Wright Test

Wright Test is used for Thoracic outlet syndrome, it's done by passively externally rotate and abduct the patient’s…
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 Wright Test

What is Wright Test?

  • Wright Test is used for thoracic outlet syndrome.
  • With repeated or continuous hyperabduction of the arm , the neurovascular structures in the axilla are stretched under the pectoral minor tendon and the coracoid process, resulting in a neurovascular syndrome.

How it's Performed?

  • It’s done by passively externally rotate and abduct the patient’s arm to 180° while having the patient turn their neck away from the tested extremity while checking the radial pulse.
  • Then he checks the other arm and compares the results.

What does a positive Wright Test mean?

  • The wright test is positive if there is an obvious weakening of the radial pulse and/or neurologic symptoms in the tested arm within a short time.

Sensitivity & Specificity

  • Sensitivity: 32 %
  • Specificity: 96 %

Notes

  • The compression occurs in the subpectoral space, between the coracoid process, the pectoralis minor, and the chest wall.
  • The compression can be evaluated at the radial artery, because it arises directly from the axillary artery, which in turn arises from the subclavian artery.
  • Both the brachial plexus and the axillary artery run through the area between the pectoralis minor muscle and the thorax.
  • They usually become compressed between the coracoid process and the pectoralis minor muscle shortly before entering the axilla.

The following should be considered in the differential diagnosis of the positive wright test:

    1. An infiltrative tumor (such as a Pancoast tumor) growing into the plexus.
    2. A tardive radiation-induced palsy.
    3. A neuroma within the brachial plexus.

Reference


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