A doctor can test for shoulder impingement using the classic Neer impingement sign test and the Hawkins modification, states the Wheeless' Textbook of Orthopaedics. Diagnosis of shoulder impingement also includes taking a complete medical history and ordering an X-ray to exclude arthritis and search for bone changes, notes WebMD.
To conduct the Neer impingement test, the patient sits or stands with his arms relaxed, explains the Minnesota State University, Mankato. The person conducting the examination holds the patient's shoulder blade using one hand and holds the elbow using the other hand. The examiner then forward flexes the patient's shoulder, looking for shoulder pain that could indicate a shoulder impingement.
To conduct the Hawkins-Kennedy impingement test, the examiner holds the patient's elbow with one hand and the patient's wrist with the other hand while the patient sits or stands, according to the Minnesota State University, Mankato. The person conducting the examination forward flexes the shoulder and then rotates it. If the movement is painful, it is possible that the patient has a shoulder impingement.
The Hawkins modification helps doctors isolate the possible tendons involved in the shoulder impingement, states the Wheeless' Textbook of Orthopaedics. While other shoulder conditions can cause pain during the Neer and Hawkins tests, an injection of lidocaine should relieve any pain if shoulder impingement is the cause. Steroid injections should also give patients with shoulder impingements several months of pain relief. If the injection does not work, the doctor may look for signs of acromioclavicular joint arthrosis or signs that the shoulder impingement is secondary.