Shoulder
Impingement
Evidence: uncertain
Posterior Impingement Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Internal Impingement (Posterior-Superior Glenoid Impingement).
- Common in throwers.
How to Perform
- Position: Patient supine. Arm abducted 90-120° and maximally externally rotated.
- Action: Examiner passively rotates the arm further into external rotation.
Interpretation of Results
- Positive Test: Deep posterior shoulder pain.
Diagnostic Accuracy
- Sensitivity: 76%
- Specificity: 85%
Clinical Context & Limitations
The Posterior Impingement 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 Posterior Impingement Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
