| 
             Glenoid Labrum Clunk Test  | 
              
              
                | 
            Other Names | 
                
				Interior 
				Derangement Test, Anterior Instability Test, Glenohumeral Labrum 
				Tear Test, Clunk Test | 
              
              
                | 
            
            Examination type | 
                
				Joint 
				stability  | 
              
              
                | 
            
            Patient & Body Segment Positioning | 
                
				The patient 
				should lie supine with the glenohumeral joint slightly over the 
				edge of the table and the shoulder completely relaxed throughout 
				the test.  The examiner should place the involved shoulder into 
				full abduction above the patient’s head with the elbow slightly 
				flexed. | 
              
              
                | 
            Examiner Position | 
                
				The examiner 
				should place one hand on the posterior aspect of the shoulder 
				over the head of the humerus, cupping the posterior aspect of 
				the shoulder with the palm on the top of the shoulder and the 
				fingers toward the axilla. The examiner’s other hand is used to 
				move the arm by holding the humerus proximal to the elbow.
				 | 
              
              
                | 
            Tissues 
            Being Tested | 
                
				Glenoid 
				labrum | 
              
              
                | 
            Performing the Test | 
                
				The examiner 
				should passively abduct and externally rotate the subject’s arm 
				overhead and apply an anterior force to the humerus. The 
				examiner then internally and externally rotates the humerus.  
				The examiner then circumducts the humeral head about the glenoid 
				labrum. | 
              
              
                | 
            
            Positive Test | 
                
				A clunk or 
				grinding noise or sensation indicates a positive test.  | 
              
              
                | 
            
            Interpretation | 
                
				Tear in the 
				glenoid labrum  | 
              
              
                | 
            
            Common errors in 
            performing exam | 
                
				The most 
				common error in performing this exam is the examiner not 
				correctly applying the appropriate degrees of passive motion. 
				The person performing the exam will often only apply sight 
				anterior pressure instead of enough to produce an accurate test 
				result. The anterior pressure is what will cause the labrum to 
				“catch” along the joint line.   | 
              
              
                | 
            
            Factors possibly 
            resulting in misinterpretation | 
                
				Extreme 
				apprehension due to recent shoulder dislocation as this test may 
				also produce apprehension if anterior instability is present. 
				Painful ROM may be due to rotator cuff impingement, strain or 
				tear instead of labrum injury | 
              
              
                | 
        Related tests | 
                
				Active 
				Compression Test (ACT) of O’Brien, Anterior Slide test, Biceps 
				Tension Test, Biceps Load Test, SLAP prehension test, Labral 
				crank test, Pain provocation test, Compression rotation test
				 | 
              
              
                | 
            
            References | 
                
				 
				Booher & 
				Thibodeau. Athletic Injury Assessment. Fourth Ed. McGraw Hill 
				Higher Ed. McGraw Hill Companies, INC. New York, NY 10020. 
				Copyright 2000. 
				Magee. 
				Orthopedic Physical Assessment. 4th Ed. 2002.  | 
              
              
                | 
            
            Links: | 
                
             
			
			
			
			http://www.hope.edu/academic/kinesiology/athtrain/program/ 
			
			studentprojects/Ldornbos2/shoulder/sld076.htm 
			
			
			
			
			http://www.chiroweb.com/archives/16/26/21.html 
			
			
			
			
			http://www.studystack.com/studytable-19704 
			
			
			
			
			http://www.aafp.org/afp/20000601/3291.html 
			
			
			
			
			http://www.orthop.washington.edu/uw/evaluation/tabID__3376/ItemID 
			
			__254/PageID__540/Articles/Default.aspx | 
              
              
                
                
                  
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