Painful Arc

Original Editor - Tyler Shultz

Top Contributors -

Tyler Shultz, Rachael Lowe and Eric Robertson  

Contents

Purpose

This test is commonly used to identify possible subacromial impingement syndrome.

Technique

The patient should be instructed to abduct the arm in the scapular plane and then slowly reverse the motion, bring the arm back to neutral position.  This test is considered to be positive if the patient experiences pain between 60 and 120 degrees of elevation. [1]

Evidence

Diagnostic Test Properties for Painful Arc Sign [2]
Sensitivity   0.33
Specificity   0.81
Positive Likelihood Ratio   1.70
Negative Likelihood Ratio  0.84


Test Item Cluster:
When this test is combined as a cluster with the Hawkins-Kennedy Impingement Sign and the Infraspinatus test, and all three tests report a positive, then the positive likelihood ratio is 10.56 and if all three tests are negative, the negative likelihood ratio is 0.17. If two of the three tests are positive, then the positive likelihood ratio is 5.03.[3]

See test diagnostics page for explanation of statistics.

References

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  1. Flynn, T.W., Cleland, J.A., & Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
  2. Calis, M., Akgun, K., Birtane, M., et al. (2000). Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis, 59, 44-47.
  3. Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.