Hornblower’s Test (Patte Test)

What is the Hornblower’s Test?

The Hornblower’s Test (also knows as Hornblower’s Sign or the Patte Test) is a common special test used in orthopedic physical assessment and examination of the shoulder. It is used to test the integrity of the muscles of the rotator cuff. The test is very simple to perform and is reliable.

Involved Structures

  • teres minor muscle
  • teres minor tendon
  • infraspinatus muscle
  • infraspinatus tendon
Teres Minor Muscle
Rotator Cuff Muscles
Michael Gasperl [Public domain], via Wikimedia Commons” href=”https://commons.wikimedia.org/wiki/File:Teres-minor.png

Starting Position

The test is usually performed with the patient in standing but can also be performed with the patient in sitting. The arm to be tested is elevated to 90 degrees of shoulder abduction in the scapular plane. The elbow is to be in 90 degrees of flexion and is externally rotated. 

Test Movement

In the starting position the examiner applies an internal rotation force to the forearm or wrist. The patient is asked to resist movement, thereby attempting to externally rotate (laterally rotate)  the shoulder. 

Positive Test

The Hornblower’s test is considered positive if pain is reported by the patient and/or significant weakness is noted by the examiner.

When referred to as the Hornblower’s Sign, it is generally considered positive if the patient is unable to hold the arm themselves in the text position; holding the arm up with the hand to the mouth as if blowing a horn.

Accuracy of Test

The Hornblower’s Test has been shown in studies to be an accurate and reliable test of teres minor integrity. However, it can be susceptible to clinical bias and its actual validity in isolating the teres minor has been brought into question.

  • Likelihood ratio: 4.81
  • SDpecificity: 96%


Video Demonstration

video source: Sebastian Gonzales

Additional Shoulder Tests of rotator cuff pathology include:

>> Return to the list of Orthopedic Tests of the Shoulder

The Bare Minimum: Donatelli Shoulder Method Assessment and Treatment

The Bare Minimum: Donatelli Shoulder Method is an evidence based book that describes the assessment and treatment techniques of Dr. Robert Donatelli and Donn Dimond. It includes mobility testing, strength tests, and special tests along with mobilization techniques and exercises for treating shoulder pathophysiology.

Special Tests for Orthopedic Examination

First published more than 20 years ago, Special Tests for Orthopedic Examination, now in its Fourth Edition, continues to follow the authors’ initial goals of providing a simple, pocket-sized manual for practical learning purposes.

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