American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following tests is indicated to assess for infraspinatus tear or tendinopathy?

1. Hawkins

2. Yergason

3. External rotation resistance

4. Painful arc

The correct answer is: External rotation resistance

The test indicated to assess for infraspinatus tear or tendinopathy is the external rotation resistance test. This test specifically evaluates the strength and integrity of the infraspinatus muscle, which is one of the four rotator cuff muscles responsible for external rotation of the shoulder. During the external rotation resistance test, the examiner applies resistance against the patient's external rotation while the patient’s arm is in a neutral position, typically at the side. A weak or painful response can indicate potential issues such as a tear or tendinopathy of the infraspinatus muscle or even related rotator cuff pathology. Other tests mentioned, such as Hawkins, Yergason, and Painful arc, serve different purposes. The Hawkins test primarily assesses for impingement of the rotator cuff tendons, while the Yergason test is designed to evaluate the stability of the biceps tendon in the bicipital groove, and the Painful arc test is used to identify subacromial impingement by assessing the range of motion during shoulder abduction. While these tests provide valuable insights into shoulder dysfunction, they do not specifically isolate issues related to the infraspinatus muscle as the external rotation resistance test does.