A positive drop arm test indicates:

Appeared in: DSSSB 14 August 2024

Explanation

The drop arm test is a specific clinical maneuver used to assess the integrity of the rotator cuff muscles of the shoulder.
A positive test occurs when the patient cannot slowly and smoothly lower their abducted arm; instead, the arm drops uncontrollably.
This dropping action is a classic sign of a tear in the rotator cuff, most commonly involving the supraspinatus tendon.

Option A: Potts fracture is an injury of the ankle, specifically involving fractures of the malleoli. It has no association with the shoulder or the drop arm test.
Option B: Golfer's elbow, or medial epicondylitis, is an overuse injury affecting the tendons on the inside of the elbow. It is assessed by examining for tenderness over the medial epicondyle and pain with wrist flexion against resistance.
Option C: Colles's fracture is a fracture of the distal radius bone in the wrist, typically caused by falling on an outstretched hand. It is diagnosed via X-ray and presents with wrist pain, swelling, and often a 'dinner fork' deformity.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Orthopedic physical assessment for shoulder injuries as background academic context rather than a clinical decision trigger.
Nurses may be asked to assist with or perform basic musculoskeletal assessments. Recognizing that the drop arm test is for the shoulder helps in correctly documenting patient complaints and physical findings.
A positive drop arm test is a significant finding that warrants reporting to the healthcare provider for further evaluation, which may include an MRI or ultrasound to confirm the diagnosis and guide treatment.
What if the patient can lower the arm but experiences significant pain (a painful arc) between 60 and 120 degrees of abduction? This is more indicative of rotator cuff tendinitis or impingement syndrome rather than a full-thickness tear.

How to Approach the Question

First, identify the key term in the question stem: 'drop arm test'.
This is a factual recall question that requires you to know the purpose of a specific clinical test.
Access your knowledge of common orthopedic assessments. Recall which part of the body the 'drop arm test' evaluates.
Systematically evaluate each option. Potts fracture is ankle, Golfer's elbow is elbow, and Colles's fracture is wrist.
Conclude that the only option related to the shoulder, which is where abduction and lowering of the arm occurs, is 'Rotator cuff injury'.

Concept Tested & Keywords

QOATBxnqMXV76PQWzYVlE0

E6 Medicine Harrison 22e Part 2 p. 847-849

E6 Osteology InderbirSingh 5e p. 49-51

Practise the full DSSSB 14 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.