Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 2, pp 424–429 | Cite as

Palpation tests versus impingement tests in Neer stage I and II subacromial impingement syndrome

  • Ugur ToprakEmail author
  • Evren Ustuner
  • Derya Ozer
  • Sadık Uyanık
  • Gul Baltacı
  • Secil Sezgin Sakızlıoglu
  • Mehmet Alp Karademir
  • Ahmet Ozgur Atay



Using sonographic findings to test the diagnostic accuracy of impingement versus tendon palpation tests in Neer stage I and II subacromial impingement syndrome cases and examine their clinical potential.


Neer and Hawkins impingement tests and rotator cuff tendon palpation tests followed by bilateral shoulder sonography were conducted on 69 patients with a clinical diagnosis of unilateral subacromial impingement.


The Neer and Hawkins tests had 74 and 62 % accuracy (sensitivity 80 and 67 %, and specificity 52 and 47 %, respectively) in comparison to 79 and 62 % accuracy rates for supraspinatus and biceps tendon palpation tests (sensitivity 92 and 41 %, and specificity 41 and 48 %, respectively). Overall, the palpation tests scored better than impingement tests in the diagnosis of Neer stage I and II subacromial impingement syndrome. No tendinosis or tear was noted in patients with negative findings in the supraspinatus palpation tests (sensitivity 100 %, specificity 21 %).


Palpation tests for supraspinatus and biceps tendons have a slightly higher accuracy than the impingement tests, and if tenderness does not exist then supraspinatus tendinopathy can be ruled out. These findings warrant the use of palpation tests in a routine physical examination for tendinopathy.

Level of evidence



Rotator cuff tendon palpation tests Neer and Hawkins impingement tests Sonography Subacromial impingement syndrome 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ugur Toprak
    • 1
    • 2
    Email author
  • Evren Ustuner
    • 3
  • Derya Ozer
    • 4
  • Sadık Uyanık
    • 1
  • Gul Baltacı
    • 4
  • Secil Sezgin Sakızlıoglu
    • 5
  • Mehmet Alp Karademir
    • 1
  • Ahmet Ozgur Atay
    • 6
  1. 1.Department of RadiologyAnkara Numune Training and Research HospitalAnkaraTurkey
  2. 2.Ankara Numune Training and Research HospitalAnkaraTurkey
  3. 3.Department of RadiologyAnkara University Medical SchoolAnkaraTurkey
  4. 4.Department of Physical Therapy and Rehabilitation, Faculty of Health SciencesHacettepe UniversityAnkaraTurkey
  5. 5.Department of RadiologyMetin Sabanci Bone and Joint Diseases Education and Research HospitalIstanbulTurkey
  6. 6.Department of Orthopedics and TraumatologyHacettepe University Medical SchoolAnkaraTurkey

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