Clarification: Empty Can and Bottle Tests Are Shoulder Examinations
The empty can test and bottle test (also called Neer's test) are physical examination maneuvers for evaluating rotator cuff pathology in the shoulder, not the hip. These tests have no relationship to hip fractures or hip pathology.
What These Tests Actually Assess
Empty can test (Jobe's test): Evaluates supraspinatus tendon integrity by having the patient elevate arms at 90 degrees in the scapular plane with thumbs pointing down (as if emptying a can), while the examiner applies downward resistance 1
Bottle test: Typically refers to shoulder impingement testing, not hip evaluation 1
If You Meant Hip Fracture Evaluation
If your question concerns a patient with suspected hip fracture following trauma, the appropriate next steps are:
Initial Imaging
- Obtain anteroposterior (AP) pelvis radiograph with cross-table lateral view of the affected hip immediately - this is the standard first-line imaging that identifies 90% of hip fractures 2, 3, 4
When Radiographs Are Negative But Clinical Suspicion Remains High
Proceed directly to MRI of the hip without IV contrast - this is the recommended second-line imaging modality with superior sensitivity for occult fractures 2, 5, 4
MRI should be obtained rather than CT or bone scintigraphy, as it provides better detection of occult fractures, bone marrow edema, and soft tissue pathology 2, 6
The patellar-pubic percussion test can help exclude radiologically occult hip fractures (negative likelihood ratio 0.05), though this has limited clinical utility compared to advanced imaging 1
Clinical Presentation to Confirm
- Anterior groin pain with inability to bear weight 3, 4
- Shortened, externally rotated, and abducted limb on examination 3, 4
Please clarify if you are asking about shoulder pathology (empty can/bottle tests) or hip fracture evaluation, as these are entirely different anatomical regions with different diagnostic approaches.