Shoulder
Rotator Cuff
Evidence: confirmed
Hornblower's Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Teres Minor (and Infraspinatus) pathology.
How to Perform
- Position: Arm abducted 90°, elbow flexed 90°.
- Action: Patient attempts to externally rotate against resistance.
Interpretation of Results
- Positive Test: Inability to externally rotate; the arm falls into internal rotation.
Diagnostic Accuracy
- Sensitivity: 100%
- Specificity: 93%
Clinical Context & Limitations
The Hornblower's Sign should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Shoulder region, combining the Hornblower's Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
