From the Guidelines
The Hawkins test is a sensitive but not specific test for rotator cuff impingement syndrome, with a sensitivity of 92% but a specificity of only 25% 1.
Key Points to Consider
- The test is used to assess for impingement of the supraspinatus tendon between the greater tuberosity of the humerus and the acromion process.
- To perform the test, the examiner flexes the patient's shoulder to 90 degrees, then internally rotates the arm while maintaining the forward flexion.
- A positive test is indicated by pain during this maneuver.
- The Hawkins test is typically used alongside other tests like the Neer impingement sign and empty can test to improve diagnostic accuracy.
Diagnostic Approach
- When evaluating rotator cuff pathology, it's essential to consider the test results in context with the patient's history, other physical examination findings, and possibly imaging studies before making a definitive diagnosis.
- Imaging studies such as MRI or ultrasound may be used to further evaluate the rotator cuff and surrounding structures 1.
Important Considerations
- The Hawkins test is not specific for rotator cuff impingement syndrome and may yield false positives.
- A comprehensive diagnostic approach, including a thorough history, physical examination, and imaging studies, is necessary to accurately diagnose rotator cuff pathology.
- The test results should be interpreted in the context of the patient's overall clinical presentation and other diagnostic findings.
From the Research
Hawkin Test with Rotator Cuff
- The Hawkins-Kennedy test has been studied in relation to shoulder impingement syndrome and rotator cuff lesions 2, 3.
- According to a study published in 1995, the Hawkins' test was used to detect shoulder impingement syndrome, and its results were compared to intraoperatively observed anatomic lesions in 55 consecutive patients who had surgery for Neer's syndrome 2.
- The study found that the sensitivity of the Hawkins' test was satisfactory, but its specificity was poor, particularly for determining the location and type of rotator cuff lesions 2.
- A more recent study published in 2018 found that the Hawkins-Kennedy test has an 80% sensitivity for subacromial impingement (SAI) 3.
- The same study also discussed other physical examination maneuvers for specific shoulder pathologies, including the Jobe test for full-thickness supraspinatus tears and the lag sign for combined full-thickness supraspinatus and infraspinatus tears 3.
- The results of these studies suggest that the Hawkins-Kennedy test can be a useful tool for detecting shoulder impingement syndrome, but its accuracy may be limited by its poor specificity for rotator cuff lesions 2, 3.
- Other tests, such as the Jobe test and the lag sign, may be more specific for certain types of rotator cuff lesions 3.