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Dropping Sign

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The patient is asked to keep the arm in external rotation. On the intact side (a), the patient can keep the arm in external rotation position when the examiner lets the arm go. On the involved side (b), the patient cannot keep the arm in external rotation, and the arm comes back to the neutral rotation after the examiner lets the arm go[1]
  • Dropping Sign
  • Walch Sign
  • Dropping Sign Test

Purpose

  • Evaluate the rotator cuff as a cause of the patients pain
  • Originally described by Walch in 1998[2]

Description

  • The patient is seated
  • Place the shoulder in 0 degrees abduction, 45 degrees external rotation, elbow flexed to 90
  • Hold the patients forearm in this position
  • Instruct the patient to maintain this position, then release the forearm
  • Positive test
    • Forearm drops back to 0 degrees internal rotation

Pathology

Evidence

Rotator Cuff Disease

  • Hermans et al [3]
    • Sensitivity: 77%
    • Specificity: 77%
    • LR+: 3.2
    • LR-: 0.35

See Also

References

  1. ↑ Itoi, Eiji. "Rotator cuff tear: physical examination and conservative treatment." Journal of orthopaedic science 18.2 (2013): 197-204.
  2. ↑ Walch, Gilles, et al. "The ‘dropping’and ‘hornblower’s’ signs in evaluation of rotator-cuff tears." The Journal of Bone & Joint Surgery British Volume 80.4 (1998): 624-628.
  3. ↑ Hermans, Job, et al. "Does this patient with shoulder pain have rotator cuff disease?: The Rational Clinical Examination systematic review." Jama 310.8 (2013): 837-847.
Created by:
John Kiel on 24 February 2025 15:43:27
Authors:
Last edited:
28 September 2025 22:20:46
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