Shoulder
Thoracic Outlet
Evidence: uncertain
Adson's Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing TOS (specifically Scalene muscle compression).
How to Perform
- Position: Patient seated. Examiner palpates the radial pulse.
- Action: Patient rotates their head towards the tested side and extends the neck while taking a deep breath and holding it.
- Extension: Examiner laterally rotates and extends the patient's shoulder.
Interpretation of Results
- Positive Test: Disappearance or significant diminution of the radial pulse.
Diagnostic Accuracy
- Sensitivity: 79%
- Specificity: 76%
Clinical Context & Limitations
The Adson's Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Shoulder region, combining the Adson's Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
