Which finding most classically helps rule in Subacromial Pain Syndrome?

Which finding most classically helps rule in Subacromial Pain Syndrome?

• A. Impingement signs (Neer, Hawkins, Empty Can/Jobe)
• B. Painful arc
• C. Pain with resisted external rotation
• D. Positive LH biceps test

Answer: (A)

Subacromial Pain Syndrome is driven by impingement of structures under the acromion during arm elevation, most notably the rotator cuff tendons and subacromial bursa. Tests that actively reproduce pain by narrowing the subacromial space during shoulder elevation are the most specific chronic indicators of this impingement process. The Neer and Hawkins-Kennedy maneuvers place the supraspinatus and subacromial tissues under compression, typically provoking a painful response if impingement is present. The empty can (Jobe) test stresses the supraspinatus and reproduces pain or weakness consistent with impingement or tendinopathy. Because these signs directly target the impingement mechanism, they most strongly support a diagnosis of Subacromial Pain Syndrome. A painful arc is common but less specific, as it can occur with other shoulder issues. Pain with resisted external rotation suggests infraspinatus involvement or broader rotator cuff pathology rather than the classic impingement mechanism. A positive tests for the long head of the biceps points to biceps tendon pathology, which can coexist but is not the defining feature of SAPS.

Subacromial Pain Syndrome is driven by impingement of structures under the acromion during arm elevation, most notably the rotator cuff tendons and subacromial bursa. Tests that actively reproduce pain by narrowing the subacromial space during shoulder elevation are the most specific chronic indicators of this impingement process. The Neer and Hawkins-Kennedy maneuvers place the supraspinatus and subacromial tissues under compression, typically provoking a painful response if impingement is present. The empty can (Jobe) test stresses the supraspinatus and reproduces pain or weakness consistent with impingement or tendinopathy. Because these signs directly target the impingement mechanism, they most strongly support a diagnosis of Subacromial Pain Syndrome. A painful arc is common but less specific, as it can occur with other shoulder issues. Pain with resisted external rotation suggests infraspinatus involvement or broader rotator cuff pathology rather than the classic impingement mechanism. A positive tests for the long head of the biceps points to biceps tendon pathology, which can coexist but is not the defining feature of SAPS.