All of the following test are used to test the posterior glenohumeral instability, EXCEPT:
Correct Answer: Sulcus test
Description: Tests for posterior shoulder instability: Jerk test: With the patient sitting and the shoulder abducted to 90 degree and medially rotated, the clinician applies a longitudinal cephalad force to the humerus and move the arm into horizontal flexion. a positive test is indicated if there is a sudden jerk as the arm is moved in to horizontal flexion and it is returned to the sta position. Posterior drawer test: The examiner passively displaces the humeral head in a posterior direction. Pain, clicking, or an increase in humeral translation indicate a positive test. Posterior apprehension test: The patient lies supine, with the shoulder flexed and internally rotated and with the elbow flexed and resting on the trunk. A posterior force is transmitted by the examiner through the subject's elbow. A look of apprehension and resistance to fuher movement constitute a positive result. Push - pull test: The patient is positioned supine with the shoulder placed at a 90 degree of scapular plane abduction. The examiner grasps the subject's wrist with one hand while the other hand is placed anteriorly near the humeral head. The examiner simultaneously pulls upward through the long axis of the forearm while pushing the humeral head posteriorly. A look of apprehension or displacement of the humeral head greater than 50% represent a positive test. Circumduction test: The patient is in standing position. The examiner stands behind the patient grasping the patient's forearm with the hand. The examiner begins circumduction by extending the patients arm while maintaining slight abduction. As the circumduction continues into elevation, the arm is brought over the top and into the flexed and adducted position. As the arm moves into forward flexion and adduction from above. it is vulnerable to posterior subluxation if the patient is unstable posteriorly. if the examiner palpate the posterior aspect of the patient shoulder as the arm moves downward in forward flexion and adduction, the humeral head will be felt to subluxate posteriorly in a positive test. Jahnke test: A Posteriorly directed force applied to the forward flexed shoulder. The shoulder i sthe moved into the coronal plane as an anteriorly directed force is applied to the humeral head. A clunk occur as the humeral head reduces from the subluxed position. Test for inferior shoulder instability Sulcus sign: The patient stands with the arm by the side and shoulder muscles relaxed. The examiner grasps the patient's forearm below the elbow and pulls the arm distally. a positive test suggesting inferior instability of the shoulder is indicated if patient's pain reproduced and/or a sulcus appears distal to the acromion. Ref: Neuromusculoskeletal examination and assessment by Nicola J. Petty, Ann P. Moore 2/e, p 195; Ohopedic Physical assessment by david J. Magee 5/e, p 288
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