Neer impingement test

Clinical test for shoulder impingement

The Neer impingement test is a clinical examination procedure used to assess shoulder impingement syndrome. This test is named after Dr. Charles Neer, who first described it as a method to diagnose impingement of the rotator cuff tendons under the acromion of the shoulder.

Procedure

The Neer impingement test is performed with the patient either sitting or standing. The examiner stabilizes the patient's scapula with one hand while passively flexing the patient's arm forward with the other hand. The arm is internally rotated, and the examiner continues to elevate the arm in the scapular plane. This maneuver compresses the supraspinatus tendon and the subacromial bursa against the anterior-inferior aspect of the acromion.

Neer impingement test being performed

Interpretation

A positive Neer impingement test is indicated by pain in the anterior or lateral aspect of the shoulder, suggesting impingement of the rotator cuff tendons or the subacromial bursa. This test is often used in conjunction with other tests, such as the Hawkins-Kennedy test, to increase diagnostic accuracy for shoulder impingement syndrome.

Clinical Significance

The Neer impingement test is a valuable tool in the clinical assessment of shoulder pain. It helps differentiate between different causes of shoulder pain, such as rotator cuff tear, bursitis, or tendinitis. However, it is important to note that a positive test alone is not diagnostic of impingement syndrome, and further imaging studies, such as MRI or ultrasound, may be required to confirm the diagnosis.

Limitations

While the Neer impingement test is widely used, it has limitations. The test may produce false positives in patients with other shoulder pathologies, such as adhesive capsulitis or glenohumeral joint arthritis. Additionally, the test's sensitivity and specificity can vary depending on the examiner's technique and the patient's anatomy.

Related pages

• Shoulder impingement syndrome
• Rotator cuff
• Hawkins-Kennedy test
• Subacromial bursitis