American Board of Internal Medicine (ABIM) Certification Practice Exam

What does a positive Hawkins test indicate?

1. Supraspinatus tendon tear

2. Subscapularis tear

3. Subacromial impingement

4. Bicipital tendinitis

The correct answer is: Subacromial impingement

A positive Hawkins test is primarily indicative of subacromial impingement. This test is performed with the patient’s arm elevated and flexed, followed by internal rotation, which reproduces pain if the rotator cuff tendons are being compressed against the acromion. Subacromial impingement syndrome frequently manifests as pain and restricted motion during activities involving overhead movements, and the Hawkins test serves as a useful clinical examination tool to detect this condition. In addition to confirming subacromial impingement, the Hawkins test can sometimes suggest underlying rotator cuff injuries, but its primary role is in identifying the impingement itself. Understanding this helps differentiate the Hawkins test from others that assess specific muscle tears or tendonitis, thus emphasizing its relevance in diagnosing subacromial impingement.