This study measured how accurate the Neer and Hawkins impingement signs are when checked against what surgeons actually find during shoulder arthroscopy. Eighty-five consecutive arthroscopy patients had their preoperative exam findings compared with the arthroscopic diagnosis. It is the first study to validate these signs against arthroscopy rather than open surgery.
Treat the Hawkins and Neer signs as screening, not confirmatory, tests. A negative result is powerful: with a combined NPV of 96% for bursitis, two negative signs let you confidently step back from a cuff or bursal diagnosis and look elsewhere.
A positive result is much weaker. Specificity sits near 44 to 51%, barely above the pretest probability, so you cannot use a positive sign alone to commit a patient to a subacromial diagnosis or injection. Remember why: the same maneuver hurts in AC arthritis, SLAP lesions, and other conditions, so a positive test tells you the shoulder hurts, not where the problem is.
This was the first work to check these classic signs against arthroscopic findings, and it grounds a durable board point: high sensitivity, low specificity, rule-out value.
This study measured how accurate the Neer and Hawkins impingement signs are when checked against what surgeons actually find during shoulder arthroscopy. Eighty-five consecutive arthroscopy patients had their preoperative exam findings compared with the arthroscopic diagnosis. It is the first study to validate these signs against arthroscopy rather than open surgery.
Treat the Hawkins and Neer signs as screening, not confirmatory, tests. A negative result is powerful: with a combined NPV of 96% for bursitis, two negative signs let you confidently step back from a cuff or bursal diagnosis and look elsewhere.
A positive result is much weaker. Specificity sits near 44 to 51%, barely above the pretest probability, so you cannot use a positive sign alone to commit a patient to a subacromial diagnosis or injection. Remember why: the same maneuver hurts in AC arthritis, SLAP lesions, and other conditions, so a positive test tells you the shoulder hurts, not where the problem is.
This was the first work to check these classic signs against arthroscopic findings, and it grounds a durable board point: high sensitivity, low specificity, rule-out value.