Test: External Rotation Lag Sign

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Background/Purpose

The external rotation lag sign was originally designed to test the integrity of the supraspinatus and infraspinatus tendons.

Procedure

The external rotation lag sign is performed with the subject seated. The elbow is passively flexed to 90° and the shoulder elevated 20° (in scapular plane) and held 5° off maximal external rotation. The subject is then asked to maintain the position actively while the examiner releases the wrist while maintaining support through the elbow. An inability to maintain the position would suggest a full-thickness tear of these tendons.
Performed: Unilaterally

Dialog

Hold the shoulder in external rotation and slightly flexed.

Criteria

• Hold arm in position
• Pain free

Measurement

LOINC Code

0

Scale/Grading

Pass/Fail