Which test is used to identify impingement in the subacromial space by elevating the arm with internal rotation?

Which test is used to identify impingement in the subacromial space by elevating the arm with internal rotation?

• A. Neer test
• B. Cross-body adduction
• C. O'Brien's test
• D. Hawkins-Kennedy

Answer: (D)

Subacromial impingement occurs when the space under the acromion narrows as the arm elevates, compressing the rotator cuff tendons (especially the supraspinatus) and surrounding bursa. The Hawkins-Kennedy maneuver specifically provokes this compression by elevating the arm while the humerus is in internal rotation. With the shoulder flexed and the elbow bent, the arm is rotated inward, which narrows the subacromial space and places压力 on the tendons beneath the acromion. A positive reproduction of pain indicates impingement in the subacromial space. Other tests target related structures or use different mechanics. Neer’s test also aims at impingement but uses a different elevation pattern with scapular stabilization, while Cross-body adduction stresses the AC joint and posterior structures, and O'Brien’s test is more about labral or AC joint pathology. The described maneuver—elevation with internal rotation—best aligns with Hawkins-Kennedy for identifying subacromial impingement.

Subacromial impingement occurs when the space under the acromion narrows as the arm elevates, compressing the rotator cuff tendons (especially the supraspinatus) and surrounding bursa. The Hawkins-Kennedy maneuver specifically provokes this compression by elevating the arm while the humerus is in internal rotation. With the shoulder flexed and the elbow bent, the arm is rotated inward, which narrows the subacromial space and places压力 on the tendons beneath the acromion. A positive reproduction of pain indicates impingement in the subacromial space.

Other tests target related structures or use different mechanics. Neer’s test also aims at impingement but uses a different elevation pattern with scapular stabilization, while Cross-body adduction stresses the AC joint and posterior structures, and O'Brien’s test is more about labral or AC joint pathology. The described maneuver—elevation with internal rotation—best aligns with Hawkins-Kennedy for identifying subacromial impingement.