American Board of Internal Medicine (ABIM) Certification Practice Exam

What does a positive "empty can" test indicate?

1. Infraspinatus tear

2. Supraspinatus tendon tear

3. Subscapularis tear

4. Bicipital tendinitis

The correct answer is: Supraspinatus tendon tear

A positive "empty can" test is a clinical examination used to assess the integrity and function of the supraspinatus muscle and tendon. During this test, the patient is asked to elevate their arm to about 90 degrees in the scapular plane with the thumb pointing downwards (as if pouring out an empty can). The examiner then applies downward pressure on the arm while the patient is instructed to resist this force. If the supraspinatus tendon is intact, the patient should be able to maintain the position without significant pain or weakness. However, if there is a tear in the supraspinatus tendon, the patient will experience pain, weakness, or an inability to hold the position against resistance, indicating a positive result. This test is particularly sensitive to supraspinatus pathology, which is a common site of injury in rotator cuff tears. Other conditions, such as infraspinatus or subscapularis tears, are typically evaluated with different tests that target those specific muscles. Thus, a positive "empty can" test specifically points to issues with the supraspinatus tendon.