Special tests for TOS |
Special tests for TOS |
Special tests for
TOS |
Adson’s test |
The shoulders are adducted to 30° in fully
extended position. The neck is extended and turned towards symptomatic
side. With the patient taking and holding deep breath, the radial artery
is palpated and compared to baseline. |
Positive test: diminished or
loss of radial artery pulsation. |
Cyriax release test |
With patient in sitting or standing
position, the forearms is grasped from under, the elbows is held at 80°
of flexion with the forearms and wrists in neutral. The trunk is leaned
posteriorly and the shoulder girdle is passively elevated. This position
is held for up to 3 minutes. |
Positive test: paresthesia and/or
numbness (release phenomenon) occur, including reproduction of
symptoms. |
Halstead maneuver
(costoclavicular maneuver or exaggerated military brace test)
|
With patient in standing position, both shoulders are drawn back, the
humerus is extended back, and the chest is protruded forward. The radial
artery is palpated and compared to baseline.
|
Positive test: diminished or loss of radial artery pulsation.
|
Roos test
(Elevated arm stress test)
|
Both shoulders are adducted to 90°, then the elbows are flexed to 90°.
Hands are pumped over 3 minutes.
|
Positive test: symptoms reproduced; inability to complete test due to
symptom limitation; arm pallor in aTOS; cyanosis and swelling in
vTOS.
|
Supraclavicular pressure |
Examiner places fingers between the
anterior scalene and upper trapezius muscle, and squeeze for 30 seconds. |
Positive test: paresthesia indicates brachial plexus compression
through the scalene triangle. |
Wright test
(hyperabduction test)
|
With patient in sitting position, the arm is passively brought into
abduction and external rotation to 90° without tilting the head, the
elbow is flexed no more than 45°, then the arm is held for 1
minute.
|
Positive test: decrease in the radial pulse and/or reproduction of the
patient’s symptoms.
|
Other tests in the article |
Other tests in the article |
Other tests in
the article |
Cross-body test |
The shoulder is forward flexed to 90°, then
adducted horizontally across the chest. |
Positive test: pain over the
acromioclavicular joint, indicating acromioclavicular joint
degeneration/arthritis. |
Hawkins test |
The patient’s arm is placed in 90° of shoulder
flexion with the elbow flexed to 90° and then the arm is internally
rotated. |
Positive test: pain with internal rotation, indicating
subacromial impingement. |
Neer test |
With patient in standing position and arm at side
of body with elbow fully extended, the arm is internally rotated and
forcefully moved through the full range of forward flexion or until
reports of pain. |
Positive test: pain in the anterior – lateral aspect
of the shoulder, indicating subacromial impingement. |
O’Brien’s test |
With the patient in sitting or standing, the
arm is placed in 90° of shoulder flexion and 10-15° of horizontal
adduction, then the shoulder is fully internally rotated and the elbow
is pronated with a distal stabilizing force is applied by examiner as
the patient is applying an upward force. The test is then repeated but
with the arm in neutral rotation. |
Positive test: pain and/or clicking
when the arm is in full internal rotation but not when the arm is in
neutral rotation, indicating labral (SLAP Lesion) or acromioclavicular
lesions. |