Shoulder Special Tests Flashcards
Dugas Test
Instruction: Pt seated, examiner instructs pt to place the hand of the affected side on the opposite shoulder then bring the effected elbow to chest
Positive: Inability to touch the opposite shoulder and/or the inability of the elbow to touch the chest
indicates: Acute dislocation of the shoulder (glenohumeral joint)
Confirmation test: apprehension test, Radiography
Anterior Apprehension test
Instruction: pt seater, examiner abducts the patients shoulder, flexes the patients elbow and then gradually externally rotates to the patients shoulder
positive: patient will have a noticeable look of apprehension or alarm on their face with possible pain
indicates: chronic anterior dislocation of the shoulder (glenohumeral joint)
Confirmation tests:
Dugas test, radiography
Posterior Apprehension test
Instruction: pt supine, examiner flexes pts shoulder, flexes pts elbow, and internally rotates the patients shoulder. Examiner places his/her hand on the patients distal humerus and gradually applies increasing posterior pressure
Positive: Patient will have a noticeable look of apprehension or alarm on their face with possible pain
indicates: chronic posterior dislocation of the glenohumeral joint
confirmation tests: Dugas test, Radiography
Drop Arm Test
AKA Codman Drop Arm Test
Instruction: pt seater, examiner passively abducts patients arm to slightly over 90 degrees and removes support. If the pt can maintain arm, then instruct to slowly lower their arm.
positive: Patient will not be able to lower the arm slowly or the arm drops suddenly
Indicates: Rotator cuff tear, usually supraspinatus
Confirmation tests:
Apley scratch, impingement sign
Drawbarn Test
Deep palpation of the shoulder elicits will localized tender area by subacromial bursa
Instruction: pt seated, examiner applies pressure below the affected acromial process with his/her finger tips. Note for pain or tenderness. Examiner continues to apply pressure while abducting the patient’s arm past 90 degrees
positive: decrease in pain and/or tenderness
indicates: subacromial bursitis
confirmation test:
MRI
Yergason Test (Cipriano)
Instuction: pt is seater, examiner flexes pts elbow to 90 degrees. Examiner stabilizes pts elbow with one hand and exerts slight inferior traction. Examiner uses their other hand and grasps slightly above the patients wrist. Examiner offers resistance while pt is instructed to externally rotate his/her humerus and slightly supinate the forearm
positive:
1. localized pain and or tenderness in the bicipital grove
2. Audible click or the biceps tendon subleuxes or dislocates
indicates:
1, tendinitis
2. instability of the biceps tendon possibly associated with a torn transverse humeral ligament
confirmation tests
Abbott-Sanders Test, Speed Test
Abbot Sunders Test
Instruction: pt seated, examiner fully abducts and externally rotates the patients affected arm. Examiner places his/her fingers on the patients bicipital groove and then slowly lowers the patients affected are to their side.
positive: palpable and/or audible click
indicates: sublexation or dislocation of the biceps tendon (rupture of the transverse ligament or tendon sublexation beneath subscapularis muscle belly)
confirmation tests:
speed test, yergason test
Speed Test
Instruction: Patient seated with forearm supinated, and elbow flexed to 45 degrees. Examiner places his/her fingers on pts bicipital groove with their opposite hand on the pts forearm. Instruct the pt to flex his/her shoulder, maintain supination and completely extend the elbow as the Dr applies resistance.
Positive: pain and/or tenderness in the bicipital groove
Indicates: bicipital tendinitis
confirmation test: abbott-saunders test, yergason test
Apley Test
Instruction: Patient seated. have him/her place the affected hand behind head and touch the opposite superior angle of the scapula = Apley scratch superior. Then pt is instructed to place the hand behind the back to touch inferior angle of the scapula = Apley scratch inferior.
positive: exacerbation of pain
indicated: degenerative tendinitis of rotator cuff tendons (usually supraspinatus).
Impingement Sign
Instruction: patient seated with arms at side, examiner slightly abducts patient’s arm (hand should be pronated) and moves it fully thought flexion (will jam greater tuberosity and anterior/inferior acromion)
positive: pain in the shoulder
indicates: overuse injury to the supraspinatus and possibly biceps tendon
