Shoulder
Drop sign
- What you examine
- Tear of infraspinatus and teres minor.
- Procedure
- Passively bring the arm into 90 degrees of abduction and near-full external rotation, elbow at 90 degrees. Let go and ask the patient to hold the position.
- Positive when
- At 90 degrees of abduction, the forearm drops back into internal rotation: the patient cannot hold the external rotation.
- What the test is worth
- Specificity around 0.95 for a substantial infraspinatus tear; sensitivity lower. A positive sign is convincing, a negative one rules out little.
- Caution
- Pain can also make holding impossible without a tear being present. Always ask whether it is pain or weakness.
- Body region
- Shoulder