Moving Valgus Stress Test is used to evaluate the Medial Ulnar Collateral Ligament Injury (Valgus Instability).
How it’s Performed?
The patient stands upright with the shoulder held in 90 degrees abduction.
The examiner brings the elbow into maximal flexion under moderate valgus stress until the shoulder has reached its greatest possible external rotation.
While applying a constant valgus pressure, the examiner quickly extends the elbow to about 30° of flexion.
What does a positive Moving Valgus Stress Test mean?
If the test recreates the same pain that the patient complained of during bodily activity, and if the pain is greatest in the “pain zone” between 120 and 70 degrees during extension of the elbow, this suggests with a high degree of sensitivity that there is instability of the medial capsular ligament apparatus.
Sensitivity & Specificity
A Cohort study by Shawn W O’Driscoll1 found that the moving valgus stress test was highly sensitive and specific when compared to assessment of the medial collateral ligament by surgical exploration or arthroscopic valgus stress testing.
Sensitivity: 100 %
Specificity: 75 %
Posttraumatic Valgus Instability:
This type is often associated with disruption of the soft tissues on the medial side of the elbow, including the medial collateral ligament, and the common flexor and pronator origin.
Valgus instability is usually found in patients with radial head fractures associated with tears of the medial collateral ligament, or in patients with severe elbow instability following a dislocation that has disrupted the lateral ligament complex.
Chronic Valgus Instability:
This type typically occurs from repetitive microtrauma or overload, resulting in attenuation or rupture of the anterior band of the medial collateral ligament.
Shawn W O’Driscoll, Richard L Lawton, Adam M Smith: The “moving valgus stress test” for medial collateral ligament tears of the elbow. PMID: 15701609
Clinical Tests for the Musculoskeletal System 3rd Edition.
Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.