Test library › Shoulder & upper arm
Kim test
For: Posteroinferior labral lesion
Website-only test: not part of the book.
A tear of the labrum, the rim of cartilage around the shoulder socket, at the back and lower part of the socket. It is linked with the shoulder slipping backwards (posterior instability).
Treat with caution (see below)Specificity and likelihood ratios calculated from the study's counts (24 of 30 lesions positive; 9 of 142 shoulders without a lesion positive); the paper reports specificity as 94%.
Caution: Single study by the test's developers, with only 30 lesions; not independently re-tested.
These figures have not been confirmed against the full paper (checked against the abstract or a secondary source only).
How it is done
Patient sitting, arm abducted to 90°. The examiner holds the elbow and the upper arm, applies a firm axial load along the humerus, then lifts the arm 45° diagonally upward while pushing the upper arm downward and backward. Positive, as defined in the study: a sudden onset of posterior shoulder pain and a click, with or without a clunk.
What the studies found
Posteroinferior labral lesion. Kim et al. 2005 tested 172 painful shoulders against arthroscopy; 30 had a posteroinferior labral lesion. The Kim test was positive in 24 of the 30, and in 9 of the 142 shoulders without a lesion. It was more sensitive for lesions mainly at the lower (inferior) labrum, while the jerk test was more sensitive for lesions mainly at the back; using both tests together raised sensitivity to 97%. Developers' own study; not independently re-tested.
What the numbers mean
- Positive result: see the caution above before relying on this result.
- Negative result: a small shift: a negative result nudges the diagnosis down, but does not exclude it.
The ladder: what a result does to your estimate
| If you thought | After a positive | After a negative |
|---|---|---|
| 10% | 58% | 2% |
| 30% | 84% | 8% |
| 50% | 93% | 17% |
Calculated from the likelihood ratios above. Read the caution above before relying on these. For any other starting estimate, use the probability calculator.
Work out what a result means for your patient: probability calculator
Other tests in the library for posteroinferior labral lesion
Source
Kim SH, Park JS, Jeong WK, Shin SK. The Kim test: a novel test for posteroinferior labral lesion of the shoulder—a comparison to the jerk test. Am J Sports Med. 2005;33(8):1188–1192. Journal article (DOI) · single study
Website-only test: added to the library on 9 October 2026 and not part of Rule It In, Rule It Out. Figures independently checked against the sources cited above; any note above says where only the abstract could be checked. If a newer or better study changes them, this page will be updated.
Get the book for the shoulder questions that matter: neck or shoulder, a painful cuff or a torn one, and an unstable joint or the labrum
This test is in the website library only; it is not one of the tests in Rule It In, Rule It Out. The book covers the tests in its ‘The shoulder’ chapter: how to do each one, what counts as positive, and how to read the result.
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