G'day Scott,
There is another test that may be of help in case of suspicion of labral
lesions:
AMERICAN JOURNAL OF SPORTS MEDICINE
Volume 26, Number 5, September-October 1998
The Active Compression Test: A New and Effective Test for Diagnosing Labral
Tears and Acromioclavicular Joint Abnormality
Stephen J. O'Brien, MD, Michael J. Pagnani, MD, Stephen Fealy, MD, Scott R.
McGlynn, and Joseph B. Wilson
From the Department of Sports Medicine and Shoulder Service, The Hospital
For Special Surgery, New York, New York
Labral tears and acromioclavicular joint abnormalities were differentiated
on physical examination using a new diagnostic test. The standing patient
forward flexed the arm to 90° with the elbow in full extension and then
adducted the arm 10° to 15° medial to the sagittal plane of the body and
internally rotated it so that the thumb pointed downward. The examiner,
standing behind the patient, applied a uniform downward force to the arm.
With the arm in the same position, the palm was then fully supinated and the
maneuver was repeated. The test was considered positive if pain was elicited
during the first maneuver, and was reduced or eliminated with the second.
Pain localized to the acromioclavicular joint or "on top" was diagnostic of
acromioclavicular joint abnormality, whereas pain or painful clicking
described as "inside" the shoulder was considered indicative of labral
abnormality. A prospective study was performed on 318 patients to determine
the sensitivity, specificity, and positive and negative predictive values of
the test. Fifty-three of 56 patients whose preoperative examinations
indicated a labral tear had confirmed labral tears that were repaired at
surgery. Fifty-five of 62 patients who had pain in the acromioclavicular
joint and whose preoperative examinations indicated abnormalities in the
joint had positive clinical, operative, or radiographic evidence of
acromioclavicular injury. There were no false- negative results in either
group.
R.,
Frank
----- Original Message -----
From: "Scott Epsley" <[log in to unmask]>
To: <[log in to unmask]>
Sent: woensdag 26 september 2001 13:18
Subject: Clunk and relocation tests
HI all,
Can anybody help me with specific details on the clunk and relocation tests.
I use a series of routine tests on the shoulder, but these are referred to
in the literature quite frequently. I think they are similar to ones I use
but I'm not sure. Does any one know? While I'm on this train of thought,
I've forgotten what Obers test is.
Thanks,
Scott.
---
Scott Epsley
BPhty., MAPA, SPG.
PRINCIPAL PHYSIOTHERAPIST
Clifford Chambers Sports Medicine
Suite 4, 120 Russell Street
Toowoomba QLD 4350
Australia
e-mail: [log in to unmask]
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