Neer's Test for Shoulder Impingement: How to Perform and Interpret It

Neer's test is a clinical examination maneuver used to detect subacromial impingement syndrome (SIS), one of the most common causes of shoulder pain. The test involves forced elevation of the arm while the examiner stabilizes the scapula, reproducing pain when subacromial structures are compressed. This article provides clinicians and students with a practical framework for performing Neer's test, interpreting its results within a broader diagnostic workup, and understanding its documented strengths and limitations based on published diagnostic accuracy studies.

Clinical Context and Anatomical Basis

Subacromial impingement syndrome encompasses a spectrum of conditions affecting the subacromial space, ranging from bursitis to partial or complete rotator cuff tears. The condition arises when the soft tissues passing beneath the coracoacromial arch become compressed during arm elevation. The supraspinatus tendon, subacromial bursa, and long head of the biceps tendon occupy this confined space, and any reduction in the available clearance can produce mechanical irritation and pain.

Neer's test targets this mechanical compression directly. The maneuver forces the greater tuberosity of the humerus against the anteroinferior aspect of the acromion, reproducing the impingement that occurs during overhead activities. Understanding this mechanism matters for clinical reasoning because a positive test indicates mechanical compression of subacromial structures, but it does not by itself identify which specific structure is compromised.

The test was developed within a conceptual framework that distinguished between outlet impingement, where the coracoacromial arch compresses the rotator cuff, and non-outlet causes of shoulder pain. This distinction remains clinically relevant because management decisions differ based on whether the primary pathology is mechanical impingement, rotator cuff tendinopathy, or intra-articular disease. A study examining a new internal rotation resistance strength test specifically aimed to differentiate intra-articular pathology from outlet impingement syndrome, highlighting the clinical need to distinguish these conditions through examination techniques (Internal rotation resistance strength test: A new diagnostic test to differentiate intra-articular pathology from outlet (Neer) impingement syndrome in the shoulder).

At a Glance: Neer's Test Summary

Step-by-Step Procedure for Performing Neer's Test

Patient Positioning and Examiner Stance

Position the patient in a seated or standing position with the back supported. The examiner stands beside the affected shoulder, facing the patient. The patient should be relaxed, with the arm in a neutral position at the side. Explain the procedure before beginning so the patient understands that discomfort may occur and can report pain accurately.

Scapular Stabilization

Place one hand on the patient's scapula to prevent upward rotation and elevation of the shoulder girdle. This stabilization is essential because it ensures that the humeral head moves against a fixed scapula, maximizing compression of subacromial structures. Without adequate stabilization, the patient may shrug the shoulder, allowing the acromion to move away from the humeral head and reducing the mechanical stress on the impinged tissues.

Arm Elevation Maneuver

With the patient's arm in neutral rotation, the examiner grasps the patient's forearm or wrist and passively elevates the arm in the scapular plane. The scapular plane is approximately 30 to 45 degrees anterior to the coronal plane, which aligns the humeral head with the glenoid and optimizes the impingement position. Continue elevation through the full available range of motion, moving the arm from the side to above the head.

The examiner should apply smooth, controlled force without sudden jerking movements. The maneuver compresses the greater tuberosity against the anteroinferior acromion, reproducing the mechanical environment that provokes symptoms during overhead activities. The test is considered positive when this maneuver reproduces the patient's characteristic shoulder pain.

Modified Neer's Test Variations

Some clinicians use a modified version of Neer's test that includes internal rotation of the arm during elevation. Internal rotation brings the greater tuberosity into closer contact with the acromion and may increase the sensitivity of the maneuver for detecting impingement. A study on the diagnostic value of a modified Neer test in identifying subacromial impingement syndrome examined this variation, though the published record provides bibliographic information without detailed results (The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome).

Neer's Sign Versus Neer's Test

A distinction must be made between Neer's sign and Neer's test. Neer's sign refers to the reproduction of pain during passive arm elevation without any additional intervention. Neer's test adds a diagnostic component: after the sign is elicited, the examiner injects a local anesthetic into the subacromial space and repeats the elevation maneuver. If pain is substantially reduced or eliminated after the injection, the test confirms that subacromial structures are the source of symptoms.

The 2025 prospective study on diagnostic accuracy used this two-stage approach, including patients with a positive Neer's sign who then underwent subacromial lignocaine injection followed by reassessment (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). This distinction matters in clinical practice because the injection component adds diagnostic specificity by confirming that anesthesia of the subacromial space abolishes the pain.

Interpretation of Results

What a Positive Test Means

A positive Neer's test indicates that compression of subacromial structures reproduces the patient's pain. The 2025 study of 500 shoulders found that Neer's test demonstrated a sensitivity of 79.0% and a specificity of 63.2% when compared against MRI as the reference standard (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). The positive predictive value was 90.1%, meaning that when the test is positive, the probability of SIS being present on MRI is high.

The test showed greater sensitivity for partial supraspinatus tears, reaching 90%, but with lower specificity in this subgroup. This finding suggests that Neer's test is particularly useful for detecting partial-thickness rotator cuff pathology, which is clinically relevant because these tears are common and may be missed on initial evaluation.

What a Negative Test Means

A negative Neer's test provides useful information for ruling out SIS. The negative predictive value of 41.4% in the 2025 study indicates that a negative test does not definitively exclude SIS, but the test's sensitivity of 79.0% means that most patients with SIS will have a positive test. A systematic review and meta-analysis found that Neer's sign was more useful for ruling out instead of ruling in SIS, with pooled sensitivity estimates ranging from 0.69 to 0.78 and specificity ranging from 0.57 to 0.62 (Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis).

The same meta-analysis reported that a negative Neer's sign reduces the probability of SIS from 45% to 14% in a population with a pre-test probability of 45%. This substantial reduction in probability makes the test valuable as a screening tool, particularly in primary care settings where advanced imaging may not be immediately available.

Diagnostic Accuracy Across Different Pathologies

The diagnostic performance of Neer's test varies depending on the specific subacromial pathology being evaluated. The 2025 study found that diagnostic accuracy was higher for rotator cuff pathologies at 81.6% compared to subacromial bursitis at 70.4% (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). This variation reflects the different mechanical relationships between the test maneuver and specific tissue pathologies.

A 2020 study of 100 shoulders similarly concluded that Neer's test is sensitive for diagnosing SIS, especially for partial rotator cuff tears, with higher specificity for rotator cuff pathology than for bursitis (To determine the efficacy of Neer's test in the diagnosis of subacromial impingement of the shoulder). A negative test was particularly useful for ruling out partial or total rotator cuff tears, while a positive test encouraged the examiner toward a diagnosis of SIS.

Combining Neer's Test with Other Clinical Tests

Sequential Testing Approach

Individual clinical tests for SIS have limited standalone diagnostic value. A Bayesian analysis of shoulder examination tests emphasized that diagnostic reasoning should integrate pre-test probability with likelihood ratios instead of relying on binary interpretations of individual tests (Reframing diagnostic reasoning: the Bayesian imperative in shoulder examination). The analysis demonstrated that even tests with comparatively higher pooled likelihood ratios produce only moderate shifts in diagnostic probability when applied alone.

However, when multiple tests are applied sequentially, the combined effect results in a substantial increase in post-test probability. The analysis showed that sequential application of tests could increase post-test probability to approximately 63%, compared to approximately 51% for a single positive test. Importantly, the final post-test probability remains invariant to the order of test application due to the multiplicative nature of likelihood ratios, though the intermediate diagnostic trajectory differs depending on the sequence.

Commonly Combined Tests

In clinical practice, Neer's test is typically combined with the Hawkins-Kennedy test, the painful arc test, and the empty can test. The systematic review and meta-analysis found that the Hawkins-Kennedy test, Neer's sign, and empty can test were more useful for ruling out instead of ruling in SIS, with greater pooled sensitivity estimates than specificity estimates (Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis).

A 2010 cross-sectional study of 34 participants with chronic shoulder pain found that the Hawkins and Kennedy test was the most accurate test for diagnosing any degree of subacromial impingement syndrome at 71.0% (The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy). The most accurate tests for diagnosing subcategories of impingement varied, with pain on resisted external rotation and weakness during the full can test being most accurate for subdeltoid fluid, pain on resisted external rotation for partial thickness tears, and the painful arc test for full thickness tears.

Practical Testing Sequence

A practical approach involves performing Neer's test first as a screening maneuver, followed by the Hawkins-Kennedy test to assess impingement through a different mechanical pathway. If both tests are positive, the likelihood of SIS increases. The examiner should then perform the empty can test and resisted external rotation to assess rotator cuff integrity. Weakness or pain during these resisted tests suggests rotator cuff pathology that may require imaging confirmation.

The examiner should record the results of each test separately instead of combining them into a single impression. This documentation allows for calculation of post-test probability using likelihood ratios and provides a clearer picture of which specific structures are involved.

Diagnostic Performance Data and Evidence Quality

Summary of Published Accuracy Data

Evidence Quality Considerations

The diagnostic accuracy of Neer's test varies substantially across studies, with sensitivity, specificity, and likelihood ratios typically presented as ranges that do not adequately reflect study weighting or uncertainty (Reframing diagnostic reasoning: the Bayesian imperative in shoulder examination). This variation stems from differences in reference standards, patient populations, and test administration techniques.

Studies using MRI as the reference standard may classify patients differently than studies using arthroscopy or open surgery. MRI can detect structural abnormalities that may not be symptomatic, potentially leading to false-positive classifications of SIS. Conversely, arthroscopy may miss subtle pathology that MRI detects. These differences in reference standards contribute to the heterogeneity observed across diagnostic accuracy studies.

The 2010 study concluded that clinical tests have limited use in informing diagnosis due to variable predictive values, and suggested that emphasis on the management of dysfunction may be more appropriate than reliance on clinical tests with inconclusive sensitivity and specificity if ultrasound scanning is not available (The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy). This perspective highlights the importance of integrating clinical examination with imaging when available.

Practical Implementation in Clinical Settings

Assessment Workflow

Begin with a thorough history, including the onset and duration of symptoms, aggravating and relieving activities, and any history of trauma. The 2025 study included patients with unilateral or bilateral shoulder pain of at least three weeks duration, suggesting that acute injuries may require different diagnostic considerations (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement).

Perform a systematic physical examination that includes inspection for muscle atrophy, palpation for tenderness, assessment of active and passive range of motion, and strength testing. Then perform Neer's test followed by the Hawkins-Kennedy test, painful arc test, and empty can test. Record the results of each test and note whether pain is reproduced in the specific location where the patient experiences symptoms.

Documentation Requirements

Record the following information for each patient:

• Patient demographics including age and sex
• Duration and nature of symptoms
• Results of each impingement test performed
• Whether Neer's sign or Neer's test with injection was used
• Response to any diagnostic injection
• Range of motion measurements
• Strength assessment findings
• Functional limitation scores

This documentation supports clinical reasoning and provides a baseline for monitoring treatment response. It also facilitates communication with other healthcare providers who may be involved in the patient's care.

When to Use the Injection Component

The injection component of Neer's test adds diagnostic information by confirming that anesthesia of the subacromial space abolishes the pain. A study on subacromial corticosteroid injections found that accurate injections produced a positive Neer's impingement test more often than inaccurate injections, with 35 of 39 accurate injections producing a positive test compared to 9 of 16 inaccurate injections (The accuracy of subacromial corticosteroid injections: a comparison of multiple methods). The overall accuracy of subacromial injection was 70%, with no difference among anterolateral, lateral, or posterior portals.

The injection component should be reserved for cases where the diagnosis remains uncertain after initial examination or where confirmation of subacromial pathology would change management decisions. The procedure requires appropriate training and should be performed under sterile conditions. Patients should be informed about the purpose of the injection and the expected effects.

Common Failure Patterns and Pitfalls

Inadequate Scapular Stabilization

Failure to stabilize the scapula during arm elevation is the most common technical error. Without stabilization, the scapula rotates upward during elevation, allowing the acromion to move away from the humeral head and reducing compression of subacromial structures. This error can produce false-negative results, leading the examiner to miss SIS that is actually present.

Incorrect Arm Rotation

The arm should be in neutral rotation during the standard Neer's test. Internal rotation increases the mechanical stress on subacromial structures and may produce pain in patients without SIS, leading to false-positive results. External rotation may reduce impingement and produce false-negative results. The examiner should maintain consistent arm positioning throughout the maneuver.

Confusing Pain Location

A positive test requires reproduction of the patient's characteristic pain, beyond any discomfort during the maneuver. Many patients experience a stretching sensation or mild discomfort during full elevation that differs from their symptomatic pain. The examiner should ask the patient whether the pain reproduced during the test is the same pain they experience during daily activities.

Overinterpretation of Positive Results

The moderate specificity of Neer's test means that positive results can occur in patients without SIS. The 2025 study found a specificity of 63.2%, meaning that approximately 37% of patients without SIS will have a positive test (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). Positive results should be interpreted within the context of the full clinical picture and confirmed with imaging when management decisions depend on diagnostic certainty.

Underappreciation of Negative Results

A negative Neer's test provides useful information for ruling out SIS, particularly partial rotator cuff tears. The 2020 study emphasized that a negative test is especially useful in ruling out the presence of partial or total rotator cuff tears (To determine the efficacy of Neer's test in the diagnosis of subacromial impingement of the shoulder). Clinicians should not dismiss a negative test as uninformative but should use it to adjust the probability of SIS downward.

Limitations and Diagnostic Uncertainty

Reference Standard Variability

The diagnostic accuracy of Neer's test depends on the reference standard used for comparison. Studies using MRI, ultrasound, arthroscopy, or open surgery as reference standards may produce different accuracy estimates because these modalities detect different aspects of subacromial pathology. MRI can identify structural abnormalities with high resolution, while arthroscopy provides direct visualization of intra-articular structures.

Population Differences

Diagnostic accuracy estimates vary across patient populations. The 2025 study included patients with a mean age of 46.3 years and a male-to-female ratio of 2:1 (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). Results may differ in younger patients, athletes, or populations with different occupational exposures. A study of male bodybuilders found that 68% of participants had positive Hawkins-Kennedy and Neer's impingement tests, with 52% experiencing moderate pain and 52% experiencing moderate disability (Prevalence of Shoulder Impingement Syndrome Among Male Bodybuilders). These findings suggest that impingement signs are common in populations with high shoulder demands, even when symptoms may be mild.

Early-Stage Pathology

Patients with preserved shoulder range of motion but positive impingement signs may represent early-stage adhesive capsulitis instead of subacromial impingement syndrome. A 2025 study of 27 patients with unrestricted shoulder joint motion and positive impingement signs found that pain and functional scores improved after intraarticular steroid injections, suggesting that some patients diagnosed with SIS may actually have early-stage adhesive capsulitis (Ultrasonographic Validity of Clinical Shoulder Impingement Signs in Patients Without Limitation of Motion). This diagnostic uncertainty highlights the need for careful interpretation of impingement signs in patients with preserved motion.

Inter-Examiner Reliability

The reliability of clinical tests for subacromial impingement depends on examiner experience and technique. Studies examining inter-examiner reliability of clinical tests for subacromial impingement and rotator cuff integrity have been conducted, though detailed findings are not available in the public record (An assessment of the inter examiner reliability of clinical tests for subacromial impingement and rotator cuff integrity). Similarly, studies on the diagnostic accuracy and reliability of clinical signs in rotator cuff disease have been published without detailed abstracts (DIAGNOSTIC ACCURACY OF CLINICAL SIGNS IN ROTATOR CUFF DISEASE, THE RELIABILITY OF CLINICAL SIGNS IN ROTATOR CUFF DISEASE: AN ASSESSMENT OF AGREEMENT BETWEEN CLINICANS).

Imaging Correlation and Advanced Diagnostics

When to Order Imaging

Imaging should be obtained when clinical examination findings are inconclusive, when symptoms persist despite conservative management, or when surgical intervention is being considered. MRI provides detailed assessment of rotator cuff integrity, subacromial bursitis, and other soft tissue pathology. Ultrasound offers a dynamic assessment that can evaluate structures during movement and is more readily available in some settings.

The 2025 study used MRI as the reference standard and confirmed SIS in 81% of cases (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). This high prevalence of confirmed pathology in patients with positive Neer's signs supports the test's utility as a screening tool, while also highlighting that clinical examination alone cannot definitively characterize the specific pathology present.

Advanced Imaging Parameters

Recent research has explored novel imaging parameters for SIS diagnosis. A 2025 study using 3D modeling and fitted sphere analysis identified the humeral head-pseudo-moving domain volume index as a predictor of SIS with an AUC of 0.778, sensitivity of 67.0%, and specificity of 77.0% at an optimal threshold of 0.690 (3D modeling and fitted sphere analysis-based biotechniques unveil novel indicators for subacromial impingement syndrome). When new indicators were used in combination, accuracy improved to an AUC of 0.859. These advanced parameters are not yet part of routine clinical practice but may inform future diagnostic approaches.

Prediction Models for Surgical Decision-Making

Clinical prediction models that integrate anatomical characteristics, functional status, and clinical factors can guide surgical decision-making for rotator cuff tears. A 2026 study developed a prediction model using demographic information, clinical characteristics, Neer classification, Neer impingement test results, and Jobe test results, along with MRI-based measurements including acromion morphology and acromion-humeral distance (A Prediction Model for Surgical Decision-Making in Rotator Cuff Tears Using Anatomical and Functional Factors). The model's performance was evaluated across discrimination ability and calibration, demonstrating the potential for structured approaches to integrate clinical examination findings with imaging data.

Professional Escalation Criteria

When to Refer for Specialist Evaluation

Referral to an orthopedic surgeon or sports medicine specialist is appropriate when:

• Symptoms persist despite 6 to 12 weeks of conservative management
• There is significant weakness suggesting rotator cuff tear
• There is a history of trauma with suspected acute injury
• Night pain is severe and disrupts sleep
• There is significant functional limitation affecting work or daily activities
• Imaging reveals full-thickness rotator cuff tear or other surgical pathology

When to Consider Urgent Referral

Urgent referral is indicated when:

• There is suspected infection with fever, redness, or systemic symptoms
• There is suspected fracture with significant trauma
• There is acute loss of active motion suggesting massive rotator cuff tear
• There is progressive neurologic deficit
• There is suspicion of malignancy

Documentation for Referral

When referring a patient, include the results of Neer's test and other impingement tests, the duration and nature of symptoms, functional limitation scores, imaging findings if available, and the response to any prior treatment. This information supports efficient specialist evaluation and reduces the need for repeated testing.

Safety Considerations and Patient Communication

Explaining the Test to Patients

Before performing Neer's test, explain that the maneuver may reproduce their shoulder pain and that this information helps determine the cause of their symptoms. Reassure patients that the test is brief and that they can report any discomfort. The examiner should stop the maneuver if the patient experiences severe pain or requests to stop.

Contraindications and Precautions

Neer's test should be performed with caution in patients with:

• Recent shoulder surgery
• Suspected fracture or dislocation
• Severe osteoporosis
• Acute inflammatory conditions
• Known malignancy involving the shoulder

In these situations, the examiner should consider whether the diagnostic information gained from the test justifies the potential risk of exacerbating the underlying condition.

Documentation of Pain Response

Record the patient's pain response using a standardized scale, such as a 0 to 10 numeric rating scale. Note the location of pain, whether it reproduces the patient's characteristic symptoms, and the range of motion at which pain occurs. This information provides a baseline for monitoring treatment response and communicating with other providers.

Frequently Asked Questions

What is the difference between Neer's sign and Neer's test?

Neer's sign is the reproduction of pain during passive arm elevation with scapular stabilization. Neer's test adds a diagnostic injection of local anesthetic into the subacromial space, followed by reassessment of the elevation maneuver. If pain is substantially reduced after the injection, the test confirms that subacromial structures are the source of symptoms. The 2025 prospective study used this two-stage approach, including patients with a positive Neer's sign who then underwent subacromial lignocaine injection followed by reassessment (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement).

How accurate is Neer's test for diagnosing subacromial impingement syndrome?

A 2025 prospective study of 500 shoulders found that Neer's test demonstrated a sensitivity of 79.0%, specificity of 63.2%, positive predictive value of 90.1%, negative predictive value of 41.4%, and diagnostic accuracy of 76.0% when compared against MRI (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). A systematic review and meta-analysis found that Neer's sign was more useful for ruling out instead of ruling in SIS, with pooled sensitivity estimates ranging from 0.69 to 0.78 and specificity ranging from 0.57 to 0.62 (Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis).

What does a positive Neer's test mean for the patient?

A positive Neer's test indicates that compression of subacromial structures reproduces the patient's pain. The positive predictive value of 90.1% means that when the test is positive, the probability of SIS being present on MRI is high (Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement). However, the moderate specificity of 63.2% means that positive results can occur in patients without SIS, so imaging confirmation is recommended when management decisions depend on diagnostic certainty.

Can a negative Neer's test rule out shoulder impingement?

A negative Neer's test provides useful information for ruling out SIS, particularly partial rotator cuff tears. The 2020 study concluded that a negative test is especially useful in ruling out the presence of partial or total rotator cuff tears (To determine the efficacy of Neer's test in the diagnosis of subacromial impingement of the shoulder). The systematic review and meta-analysis reported that a negative Neer's sign reduces the probability of SIS from 45% to 14% in a population with a pre-test probability of 45% (Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis).

How does Neer's test compare to the Hawkins-Kennedy test?

Both tests are commonly used to assess subacromial impingement, but they use different mechanical maneuvers. Neer's test involves forced arm elevation in the scapular plane, while the Hawkins-Kennedy test involves forward flexion of the arm to 90 degrees followed by internal rotation. A 2010 study found that the Hawkins and Kennedy test was the most accurate test for diagnosing any degree of subacromial impingement syndrome at 71.0% (The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy). The systematic review found that both tests were more useful for ruling out instead of ruling in SIS (Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis).

Should Neer's test be used alone or with other tests?

Neer's test should be used as part of a comprehensive clinical examination instead of in isolation. A Bayesian analysis of shoulder examination tests emphasized that individual clinical tests have limited standalone diagnostic value and that structured, sequential test application substantially increases post-test probability (Reframing diagnostic reasoning: the Bayesian imperative in shoulder examination). Combining Neer's test with the Hawkins-Kennedy test, painful arc test, and empty can test provides a more complete assessment of subacromial pathology.

What is the role of injection in Neer's test?

The injection component of Neer's test confirms that anesthesia of the subacromial space abolishes the pain, providing evidence that subacromial structures are the source of symptoms. A study on subacromial corticosteroid injections found that accurate injections produced a positive Neer's impingement test more often than inaccurate injections, with 35 of 39 accurate injections producing a positive test compared to 9 of 16 inaccurate injections (The accuracy of subacromial corticosteroid injections: a comparison of multiple methods). The overall accuracy of subacromial injection was 70%.

How should positive impingement signs be interpreted in patients with preserved range of motion?

Patients with preserved shoulder range of motion but positive impingement signs may represent early-stage adhesive capsulitis instead of subacromial impingement syndrome. A 2025 study of 27 patients with unrestricted shoulder joint motion and positive impingement signs found that pain and functional scores improved after intraarticular steroid injections, suggesting that some patients diagnosed with SIS may actually have early-stage adhesive capsulitis (Ultrasonographic Validity of Clinical Shoulder Impingement Signs in Patients Without Limitation of Motion). This diagnostic uncertainty highlights the need for careful interpretation of impingement signs in patients with preserved motion.

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References and Further Reading

• Research Data Framework. National Institute of Standards and Technology.
• EQUATOR Network. EQUATOR Network.
• Experimental Design Assistant. NC3Rs.
• NCBI Literature Resources. National Center for Biotechnology Information.
• PubMed. National Library of Medicine.
• Diagnostic accuracy of Neer's impingement test for subacromial shoulder impingement.. Irish journal of medical science, 2025.
• Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis.. Archives of physical medicine and rehabilitation, 2012.
• The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy.. Clinical rehabilitation, 2010.
• The accuracy of subacromial corticosteroid injections: a comparison of multiple methods.. Journal of shoulder and elbow surgery, 2008.
• Reframing diagnostic reasoning: the Bayesian imperative in shoulder examination.. 2026.
• A Prediction Model for Surgical Decision-Making in Rotator Cuff Tears Using Anatomical and Functional Factors.. 2026.
• Performance of ChatGPT-5 in Diagnosing Fractures on Proximal Humerus and Intertrochanteric Femur X-Rays.. 2026.
• 3D modeling and fitted sphere analysis-based biotechniques unveil novel indicators for subacromial impingement syndrome.. 2025.
• Can Hertel Criteria Reliably Predict Avascular Necrosis After Intracapsular Proximal Humerus Fractures in the Elderly? A Retrospective Analysis.. 2026.
• Zero vs. 30: a diagnostic manual muscle testing technique for detecting full- or partial-thickness supraspinatus muscle tears.. 2025.
• What is the optimal implant removal timing following hook plate fixation in distal clavicle fractures: a retrospective analysis from subacromial osteolysis cases.. 2026.
• Ultrasonographic Validity of Clinical Shoulder Impingement Signs in Patients Without Limitation of Motion.. 2025.
• To determine the efficacy of Neer’s test in the diagnosis of subacromial impingement of the shoulder. International Journal of Orthopaedics Sciences, 2020.
• An assessment of the inter examiner reliability of clinical tests for subacromial impingement and rotator cuff integrity. European Journal of Orthopaedic Surgery & Traumatology, 2008.
• DIAGNOSTIC ACCURACY OF CLINICAL SIGNS IN ROTATOR CUFF DISEASE. 2003.
• THE RELIABILITY OF CLINICAL SIGNS IN ROTATOR CUFF DISEASE: AN ASSESSMENT OF AGREEMENT BETWEEN CLINICANS. 2002.
• Prevalence of Shoulder Impingement Syndrome Among Male Bodybuilders. Journal of Nursing and Allied Health, 2024.
• The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome. European Journal of Orthopaedic Surgery and Traumatology, 2017.
• An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs. Journal of Shoulder and Elbow Surgery, 2000.
• Internal rotation resistance strength test: A new diagnostic test to differentiate intra-articular pathology from outlet (Neer) impingement syndrome in the shoulder. Journal of Shoulder and Elbow Surgery, 2001.

This article is educational and does not replace institutional policy, professional advice, or applicable safety and regulatory requirements.