American Board of Internal Medicine (ABIM) Certification Practice Exam

What does a positive Neer test suggest?

1. Rotator cuff tendinitis

2. Infraspinatus tear

3. Adhesive capsulitis

4. Bicipital tendinitis

The correct answer is: Rotator cuff tendinitis

A positive Neer test indicates the presence of rotator cuff tendinitis. The test is performed by stabilizing the scapula and raising the arm forward in the shoulder's flexion arc. If pain is elicited during this maneuver, it suggests that the rotator cuff tendons, particularly the supraspinatus tendon, may be inflamed or irritated. Rotator cuff tendinitis, often due to repetitive overhead activities, can lead to impingement of the tendons as the arm is raised. The Neer test specifically assesses for this pain associated with the movement of the shoulder which can help in diagnosing shoulder pain attributed to rotator cuff pathology. Other conditions may present with shoulder pain as well, but they do not specifically correlate with the Neer test's mechanisms or the pain it elicits. For instance, while bicipital tendinitis also causes shoulder pain, it is more involved with tenderness in the bicipital groove rather than the specific movement assessed by the Neer test. Similarly, adhesive capsulitis and infraspinatus tears would not typically be indicated by this particular test, making a positive Neer test a more specific indicator of rotator cuff tendinitis.