The test is positive for labral pathology if pain is produced with the arm internally rotated but not externally rotated. The test is positive for AC joint pathology if there is pain with both maneuvers localized to the AC joint.
What is the O'Brien test?
The O'Brien Test is designed to maximally load and compress the ACJ and superior labrum. For maximal results the authors stress that the patient should resist the examiner's downward force rather than the examiner resisting forward flexion.
Why is the O'Brien test repeated in supination?
The procedure is repeated in supination. The O'Brien Test is designed to maximally load and compress the ACJ and superior labrum. For maximal results the authors stress that the patient should resist the examiner's downward force rather than the examiner resisting forward flexion.
How accurate is O'Brien's active compression test?
The sensitivity and specificity of the O'Brien's Active Compression Test have been reported to vary widely and no one test can accurately diagnose a SLAP Lesion. Studies have shown O'Brien's Test to have a specificity ranging from 28-73% and a sensitivity of 63-94%.
How accurate is the O'Brien's test for SLAP lesions?
Evidence. The sensitivity and specificity of the O'Brien's Active Compression Test have been reported to vary widely and no one test can accurately diagnose a SLAP Lesion. Studies have shown O'Brien's Test to have a specificity ranging from 28-73% and a sensitivity of 63-94%. However, when grouped with other tests for SLAP lesions such as...
What is a positive cross arm test?
During this manoeuvre, the examiner supports the arm of the patient with his opposite hand, while resting the other hand on the patient's opposite shoulder to maintain adduction and prevent rotation of the patient's upper body. If pain is present, this is considered to be a positive cross-arm adduction sign.
How do you diagnose a SLAP tear?
MRI is the most common imaging tool used to diagnose labral lesions, although it may not show a SLAP lesion. Therefore an MR arthrogram, where a contrast material gets injected into the shoulder, is also used. This is able to detect a SLAP tear better than a normal MRI scan.
Which secondary pathology can be found using the O Brien's test?
O'Brien's active compression test was primarily developed for assessment of Acromioclavicular joint pathology following a patient's demonstration of what reproduced their shoulder pain. O'Brien noted in a series of patients it was also excellent for detecting labral pathology.
What is the difference between a Bankart lesion and a SLAP tear?
A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the rim above the middle of the socket that may also involve the biceps tendon. A tear of the rim below the middle of the glenoid socket that also involves the inferior glenohumeral ligament is called a Bankart lesion.
What are the 4 classifications of a SLAP tear?
SLAP Tear Types and TreatmentsThe All Important Shoulder Labrum. The shoulder labrum is a ring of cartilage that sits between the shoulder socket (glenoid) and the upper arm bone (humerus). ... Type 1 SLAP Tear. ... Type 2 SLAP Tear. ... Type 3 SLAP Tear. ... Type 4 SLAP Tear. ... Typical Treatment Protocols for SLAP Tears.
What does a negative O Brien's test mean?
If this test reproduces symptoms in the acromioclavicular joint or deep within the shoulder, retest again with the arm supinated, if this is negative then this would be a positive test and you may then be suspicious of a superior labral tear from anterior to posterior (SLAP tear).
Is a SLAP tear the same as a labrum tear?
Superior Labrum, Anterior to Posterior tears (SLAP tears), also known as labrum tears, represent 4% to 8% of all shoulder injuries. The L in SLAP refers to your glenoid labrum. Your labrum plays two important roles in keeping your shoulder functioning and pain free.
Is a SLAP tear a rotator cuff injury?
(See "Society guideline links: Shoulder soft tissue injuries (including rotator cuff)".) SLAP tear refers to a specific injury of the superior portion of the glenoid labrum that extends from anterior to posterior in a curved fashion.
How do you diagnose a torn labrum in the hip?
Diagnostic testing for a hip labral tear can include medical imaging, injections, and—occasionally—arthroscopic surgery. MRI (magnetic resonance imaging) and MRI arthrogram. This type of diagnostic imaging shows a detailed view of the soft tissues surrounding the hip joint.
How serious is a torn labrum shoulder?
The labrum runs from there around the joint, both in an anterior and in a posterior direction. Due to injury in this area where the biceps tendon attaches, the labrum also can get injured. The injury in this area can be mild or it can be severe.
Can a labrum tear in the shoulder heal itself?
Typically, it takes 4 to 6 weeks for the labrum to reattach itself to the bone, with another 4 to 6 weeks to regain strength. You will have to be patient with yourself and your body during this time to make sure you do not re-injure the labrum while it is healing.
Can you lift your arm with a torn labrum?
Nonsurgical treatment Labral tears are often treated with rest, over-the-counter medications, and physical therapy. If you have a Bankart tear, your doctor (or even your coach or trainer) may be able to pop your upper arm back into place. This should be followed by physical therapy.
What is the O'Brien test?
O'Brien Test. This testis used to assess for a SLAP lesion. “The patient sits with the testshoulder in 90 degrees of forward flexion, 40 degrees of horizontal adduction, and maximal internal rotation. The examiner stands with one hand grasping the subject's wrist.
How to test for infraspinatus?
One may also ask, how do you test for Infraspinatus? The infraspinatusmuscle is best tested by externally rotating the upper arm with the elbows flexed at 90 degrees. The elbows can either be at the patient's side or abducted 90 degrees to further isolate the infraspinatusfrom the deltoid muscle.
What is Hornblower's sign?
Hornblower's Sign (Patte Test) This test is used to determine the strength of the teres minor1. “Both the therapist and the patient are standing. The therapist elevates the patient's arm to 90 degrees in the scapular plane.
What is an O’Brien test?
O’Brien Test (also known as active compression test) is used to test for labral injuries and SLAP lesions (Superior Labrum Anterior and Posterior injuries) of the shoulder joint.
What is Wright test?
Wright Test is used for Thoracic outlet syndrome, it's done by passively externally rotate and abduct the patient’s…
What is a positive labral tear?
The test is positive for a glenoid labral tear if the patient reports pain for clicking or pain “inside the shoulder” with resisted forward flexion in internal rotation of the shoulder that is relieved by External Rotation of the shoulder.
What is the purpose of the Apprehension and Relocation test?
Apprehension and Relocation test is used to test for anterior instability of the shoulder joint.
Which part of the labrum is most commonly avulsed?
Avulsion of the superior part of the labrum, the most common type.
Can the O'Brien test show acromioclavicular joint disorder?
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.
Does the O'Brien test detect a slap tear?
A study by J. Matthew Owen 2 shows that O’Brien test has a high Sensitivity and Specificity for detecting a SLAP tear, as following:
How specific is the O'Brien test?
Studies have shown O'Brien's Test to have a specificity ranging from 28-73% and a sensitivity of 63-94%.
What is the purpose of O'Brien's active compression test?
The purpose of O'Brien's Active Compression Test is to indicate potential labral ( SLAP Lesion) or acromioclavicular lesions as cause for shoulder pain.
What does it mean when you have a positive test?
A positive test occurs with pain reproduction or clicking in the shoulder with the first position and reduced/absent with the second position
What is the O'Brien test?
O’Brien’s Test is a special orthopaedic/orthopedic test for the shoulder that attempts to test specifically for glenohumeral joint labral tears (and more specifically for SLAP Lesions; superior labral tear from anterior to posterior). A false positive may occur if there is an injury to the rotator cuff or acromioclavicular (AC) joint.
What position should the arm be in for a syringe test?
The test is best performed with the patient in a relaxed sitting position but can also be performed in standing. The arm to be tested should be in 90 degrees of flexion and about 10 degrees of adduction.
What is the purpose of the examiner in a patient's arm?
The examiner provides a downward force distally on the arm while the patient resists with an upward force. The examiner can also instruct the patient to simultaneously externally rotate the arm while the examiner resists this as well. The test is then repeated but with the arm in neutral rotation.
Is a C joint a positive test?
The test is considered positive if there is pain and/or clicking when the arm is in full internal rotation but not when the arm is in neutral rotation. Pain over the acromioclavicular joint (a-c joint) indicates pathology at that joint while pain felt ‘deeper’ in the shoulder is more indicative of glenoid labrum pathology. In the event of a-c joint pathology the patient will likely complain of pain in both positions of the test.
Test
The patient is instructed to flex their arm to 90° with the elbow fully extended and then adduct the arm 10-15° medial to sagittal plane. The arm is then maximally internally rotated and the patient resists the examiner's downward force. The procedure is repeated in supination.
Positive
Pain elicited by the fIrst manoeuvre is reduced or eliminated by second.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, Wright AA. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. British journal of sports medicine. 2012 Nov 1;46 (14):964-78.
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What is the test position for bicep tendon?
As Surgeon Lennard Funk found, ‘ Arthroscopy revealed that the test position (90° forward flexion, 10-15° adduction and maximum internal rotation) displaces the biceps tendon medially and inferiorly therefore putting tension on the bicipitallabral complex. ‘ From this we can understand that the bicep plays a large role in O’Brien’s test.
What test do therapists use to diagnose shoulder pain?
But one test I always see therapists use is the O’Brien test.
What force do you want to get to stress the glenoid labrum?
You want to get the deceleration force of the biceps to stress the glenoid labrum rather than getting them to concentrically contract.
Can a single maneuver diagnose superior labral anterior posterior lesions?
Parentis et al also noted in their American Journal Of Sports Medicine article that “there is no single maneuver that can accurately diagnose superior labral anterior posterior lesions ”.
Is the O'Brien test 100% accurate?
Done in isolation the O’Brien’s test will never be 100% accurate at identifying SLAP or superior labral tears. You can see the success ratio, provided by physio-pedia, in the table below. The O’Brein’s must be combined with any other SLAP test, such as the Clunk test or the supine flexion resistance test described by Nina et al in their 2008 study. This is the only way you can gather evidence and be more confident of the extent of the cause of the shoulder injury.
