Medial/Internal Rotation Lag Sign | Subscapularis

Execution:

  1. Patient is in standing position
  2. The patient places the dorsum of the hand at the midlumbar spine
  3. The examiner moves the forearm and hand away from the body passively
  4. The examiner asks the patient to hold this position actively and removes the supporting hand and the wrist

 

Positive Outcome: Patient is unable to hold this position and the forearm and hand move forward

Study Reliability Sn Sp LR+ LR-
Miller et al. (2009) NA 100 84 6.2 0.00
Kappe et al. (2018) NA 41 91 4.6 0.6
Hertel (1996) NA 97 96 24.25 0.03
Lädermann et al. (2021) NA 32 (13-61) 92 (73-98) 1.25 (0.48-30.5) 0.99 (1.19-0.4)
Comment: If this test scores negative, a full thickness tear of the subscapularis can be excluded.