Posterolateral Apprehension Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Posterolateral Rotatory Instability (PLRI).
How to Perform
- Position: Patient lies supine with the arm overhead.
- Action: Examiner grasps the patient's wrist and elbow, applying a force that mimics the Pivot-Shift (supination + valgus + flexion).
Interpretation of Results
- Positive Test: The patient verbally expresses fear ('apprehension') that the elbow will dislocate, or resists the movement, even if no actual clunk occurs.
Clinical Context & Limitations
The Posterolateral Apprehension 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 Elbow region, combining the Posterolateral Apprehension Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
