Adson Test

 Adson Test

What is Adson Test?

Adson Test is used to evaluate the presence of Thoracic Outlet Syndrome which is a compression syndrome at the base of the neck with compromised neurovascular function.

See Also: Wright Test

How do you perform the Adson’s Test?

What does a positive Adson Test mean?

A positive Adson Test occurs when the radial pulse disappears while the affected arm is raised laterally with simultaneous turning of the head to the same side.

Adson Test Reliability

Plewa and Delinger found the specificity of this test to be 100% when assessing pain, 89% when assessing vascular changes, and 89% when assessing paresthesia.

Other TOS Test

Other tests for Thoracic Outlet Syndrome include:

Costoclavicular Test:

The patient sits with the arm s hanging relaxed. The examiner palpates the wrists to take the pulse in both radial arteries, noting amplitude and pulse rate. Then the patient abducts and externally rotates both arms and retracts the shoulders (Geisel position). With the patient in this position, the examiner again palpates the wrists and evaluates the pulse in both radial arteries.

Unilateral weakness or absence of the radial pulse, ischemic skin changes, and paresthesia are clear signs of compression of the brachial plexus and the axillary artery and vein in the costoclavicular region between the first rib and clavicle (costobrachial syndrome; droopy shoulder syndrome).

Allen Maneuver:

The patient sits or stands. The examiner stands behind the patient and flexes the patient’s elbow to 90° while the shoulder is abducted horizontally and placed into external rotation. The patient then rotates the head away from the test side.

The examiner palpates the radial pulse, which disappears when the head is rotated. This disappearance indicates a positive test result for thoracic outlet syndrome, which may be caused by clavicular fractures with excessive callus or residual displacement of fragments, a cervical rib, a bifid clavicle, or abnormalities of the scalenus medius muscle.

Roos Test:

The patient is positioned sitting. The arm is positioned in 90 degrees of shoulder abduction, and 90 degrees of elbow flexion. The patient is asked to perform slow finger clenching for 3 minutes. The radial pulse may be reduced or obliterated during this maneuver, and an infraclavicular bruit may be heard.

If the patient is unable to maintain the arms in the start position for 3 minutes, or reports pain, heaviness, or numbness and tingling, the test is considered positive for TOS on the involved side. This test is also referred to as the handsup test, or the elevated arm stress test.

No diagnostic accuracy studies have been performed to determine the sensitivity and specificity of this test.

Roos Test
Roos Test

Wright Test:

The Wright Test was discussed Here: Wright Test

Notes:

References

  1. Nichols AW. The thoracic outlet syndrome in athletes. J Am Board Fam Pract. 1996 Sep-Oct;9(5):346-55. PMID: 8884673.
  2. Plewa MC, Delinger M. The false-positive rate of thoracic outlet syndrome shoulder maneuvers in healthy subjects. Acad Emerg Med. 1998 Apr;5(4):337-42. doi: 10.1111/j.1553-2712.1998.tb02716.x. PMID: 9562199.
  3. Clinical Tests for the Musculoskeletal System 3rd Edition.
  4. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.

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