Which sign requires the patient to place the hand on the belly and press inward, potentially causing pain or inability to internally rotate?

• A. Napoleon's Sign
• B. Gerber's Lift-Off Sign
• C. Patte's Test
• D. Dropping Sign

Answer: (A)

Evaluating subscapularis function is the idea here, since this muscle is the primary internal rotator of the shoulder. Napoleon's sign specifically tests that internal rotation by having the patient place the hand on the abdomen and push inward toward the midline. If the subscapularis is injured or painful, the patient will have difficulty or be unable to press inward, sometimes with accompanying pain. This direct, abdominal position isolates the subscapularis’ role in internal rotation, so this maneuver best reveals a subscapularis problem.

Other signs test different aspects or positions of the shoulder. Gerber's lift-off uses a behind-the-back position to challenge the subscapularis, while the remaining signs assess other rotator cuff muscles or shoulder function, so they don’t specifically match the described belly placement and inward pressing.