Internal Rotation Lag Sign
Other Names
- Subscapularis Test
- Medial Rotation 'Spring Back' Test
- Lag Test
- Modified Lift-off Test
- IRLS
- Lift off lag sign
- Internal Rotation Lag Sign Test
- Internal Rotation Lag Test
- Subscapularis Lag Sign
- Subscapularis Insufficiency Test
- Internal Rotation Hold Test
- Anterior Rotator Cuff Lag Sign
Purpose
- Evaluate integrity of the Subscapularis Muscle
Description
- Patient is seated, examiner behind patient
- The patient is asked to internally rotate their arm and bring it up behind their back with the shoulder in slight extension
- The examiner then lifts the patients hand and forearm off the back
- Then ask the patient to hold their arm in that position, the examiner releases the forearm but continues to support the elbow
- Positive test
- "Lag" or fall of arm from initial position
- Note: the degree of fall may help distinguish partial from complete tears
Pathology
Evidence
- Kappe et al[5]
- Sensitivity: 41%
- Specificity: 91%
- PPV: 0.65
- NPV: 0.78
- Diagnostic Accuracy: 0.75
- (Need Citation)
- Sensitivity: 97%
- Specificity: 96%
- LR+: 24.3
- LR-: .03
Rotator Cuff Disease
- Hermans et al [6]
- Sensitivity: 97%
- Specificity: 83%
- LR+: 5.6
- LR-: 0.04
See Also
References
- ↑ Scheibel, Markus, and Peter Habermeyer. "Subscapularis dysfunction following anterior surgical approaches to the shoulder." Journal of shoulder and elbow surgery 17.4 (2008): 671-683.
- ↑ Fandridis, E., et al. "The Diagnostic Value of Subscapularis Clinical Tests in the Postoperative Diagnosis of Subscapularis Tendon retears after Arthroscopic Repair: An Ultrasound-Comparative Trial." Int J Phys Med Rehabil 6.487 (2018): 2.
- ↑ Hertel, R., and F. Ballmer. "Lag signs in the diagnosis of rotator cuff rupture." Journal of Shoulder and Elbow Surgery 4 (1995): S25.
- ↑ Dancsó, Mária. "PREVENTION OF SHOULDER GIRDLE INJURIES IN RECREATIONAL CLIMBERS–AN INTERVENTION BOOKLET." (2018).
- ↑ Kappe, Thomas, et al. "Diagnostic performance of clinical tests for subscapularis tendon tears." Knee Surgery, Sports Traumatology, Arthroscopy 26.1 (2018): 176-181.
- ↑ 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 29 July 2019 16:37:17
Authors:
Last edited:
29 December 2025 01:24:58
Category: