American Board of Internal Medicine (ABIM) Certification Practice Exam

A positive drop-arm test is suggestive of which condition?

1. Rotator cuff tear

2. Adhesive capsulitis

3. Frozen shoulder

4. Shoulder dislocation

The correct answer is: Rotator cuff tear

A positive drop-arm test is indicative of a rotator cuff tear, particularly involving the supraspinatus muscle. This test assesses the integrity of the rotator cuff, whereby a patient is asked to raise their arm fully overhead and then slowly lower it back down. If the patient experiences pain or is unable to control the descent of their arm, resulting in it "dropping," it suggests that there is a significant tear in the rotator cuff muscles. In cases of a rotator cuff tear, particularly the supraspinatus, the ability to maintain shoulder stability and control during the lowering phase of the test is compromised. This test is a clinical tool used by healthcare providers to evaluate shoulder functionality and distinguish between various shoulder pathologies. While adhesive capsulitis, which is characterized by stiffness and pain in the shoulder, and shoulder dislocation may also affect arm movement, they do not specifically lead to a positive drop-arm test result as typically observed in a rotator cuff injury. Frozen shoulder is another term commonly used for adhesive capsulitis and shares similar characteristics. Hence, the specificity of the drop-arm test for rotator cuff tears makes this the most accurate interpretation of the test result.