Clinical evaluation of the shoulder shrug sign

Xiaofeng Jia, Jong Hun Ji, Steve Petersen, Jennifer Keefer, Edward G McFarland

Research output: Contribution to journalArticle

Abstract

The "shrug sign" (inability to lift the arm to 90° abduction without elevating the whole scapula or shoulder girdle) has been associated with a diagnosis of rotator cuff disease. Based on our clinical experience, we hypothesized the shrug sign is not a specific diagnostic sign for this condition, but rather is associated with various shoulder conditions and shoulder weakness and loss of range of motion. We retrospectively reviewed 982 consecutive patients who had been examined preoperatively for the shrug sign. A positive shrug sign was present in 51.3% of the patients, and the average distance lost from the horizontal was 20.5° ± 2.2° (standard error of mean). Increasing age was associated with the presence of a shrug sign. The highest incidence was in patients with adhesive capsulitis (94.7%). The shrug sign was not sensitive for tendinosis, partial rotator cuff tears, or full-thickness or massive rotator cuff tears. The shrug sign was associated with weakness in abduction, night pain, and loss of range of motion, especially passive abduction. Although the shrug sign is useful as a general sign of shoulder abnormality, particularly when associated with stiffness, it was not specific or sensitive for rotator cuff problems. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)2813-2819
Number of pages7
JournalClinical Orthopaedics and Related Research
Volume466
Issue number11
DOIs
StatePublished - Nov 2008

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Rotator Cuff
Articular Range of Motion
Bursitis
Scapula
Tendinopathy
Arm
Guidelines
Pain
Incidence
Rotator Cuff Injuries

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Clinical evaluation of the shoulder shrug sign. / Jia, Xiaofeng; Ji, Jong Hun; Petersen, Steve; Keefer, Jennifer; McFarland, Edward G.

In: Clinical Orthopaedics and Related Research, Vol. 466, No. 11, 11.2008, p. 2813-2819.

Research output: Contribution to journalArticle

Jia, Xiaofeng ; Ji, Jong Hun ; Petersen, Steve ; Keefer, Jennifer ; McFarland, Edward G. / Clinical evaluation of the shoulder shrug sign. In: Clinical Orthopaedics and Related Research. 2008 ; Vol. 466, No. 11. pp. 2813-2819.
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