O’Brien Test

 O’Brien Test

What is O’Brien Test?

  • O’Brien Test (active compression test) is used to test for labral injuries and  SLAP lesions (Superior Labrum Anterior and Posterior injuries) of the shoulder joint.

How it's Performed?

  • Patient forward flexes the affected arm to 90 degrees while keeping the elbow fully extended.
  • The arm is then adducted 10-15 degrees across the body.
  • The patient then pronates the forearm so the thumb is pointing down.
  • The examiner applies downward force to the wrist while the arm is in this position while the patient resists.
  • The patient then supinates the forearm so the palm is up and the examiner once again applies force to the wrist while the patient resists.

What does a positive O’Brien Test mean?

  • O’Brien test is positive for SLAP tear when there is pain is “deep” in the glenohumeral joint while the forearm is pronated, but not when the forearm is supinated.

Sensitivity & Specificity

  • Sensitivity: 100 %
  • Specificity: 98 %

Notes

  • It is crucial to inquire about the location of the pain as the O’Brien test can also yield positive results in the presence of acromioclavicular joint disorders.
  • Pain reported within the shoulder suggests a SLAP lesion, whereas pain over the acromioclavicular joint may also be due to osteoarthritis of the acromioclavicular joint.

Reference

  • Clinical Tests for the Musculoskeletal 3rd Ed. Book
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325388



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