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The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
However, imaging studies are unable to show cause of shoulder pain in diagnosing. For example, MRI imaging would show rotator cuff pathology and bursitis but is unable to specify the cause. [15] On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test).
The Hawkins–Kennedy Test is a test used in the evaluation of orthopedic shoulder injury. It was first described in the 1980s by Canadians R. Hawkins and J. Kennedy, and a positive test is most likely indicative of damage to the tendon of the supraspinatus muscle. [1] [2]
Neer Impingement Test: a positive test indicates shoulder impingement syndrome; Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear
Calcification of the supraspinatus tendon is a major contributor to shoulder pain in the general population and is often worsened following a supraspinatus tear. The results of the study included the return to sports and original functionality of 95.8% of the patients after a mean of 5.3 post-operative months.
A positive test is indicated by pain in the anterior or lateral shoulder when in full flexion. It is indicative of problems involving the supraspinatus and the long head of the biceps brachii tendons. The examiner needs to be aware of a false positive test which is due to the patient having limited forward flexion. [1]
The infraspinatus and supraspinatus [13] tests have a specificity of 80% to 90%. [10] A common cause of shoulder pain in rotator cuff impingement syndrome is tendinosis, which is an age-related and most often self-limiting condition. [14]
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]