Neer's Sign and Test – Functional examination

Neer’s sign (impingement sign)

The examiner passively flexes the patient’s internally rotated arm while simultaneously applying steady downward pressure over the acromion with the other hand. The test is positive if the patient feels pain around/under the acromion when the arm flexes > 90 degrees.

Michener LA et al. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009;90(11):1898-1903

Neer test

Injection of local anesthetic into the subacromial bursa
If the patient experiences clear pain relief during retesting after local anesthesia, the test is positive
Positive test if the patient feels pain around/under the acromion when the arm is flexed > 90°

Test characteristics: Sens 81, Spec 54, LR+1.76, LR-0.35