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Cross-Arm  Test

Other Names Horizontal Adduction Test, Acromioclavicular Crossover Test, Cross-Chest Test, Crossbody Test
Examination type Bony integrity, ligamentous integrity
Patient & Body Segment Positioning Supine or standing relaxed with arms at sides.
Examiner Position Standing next to the patient on the involved side.  One hand should be placed at the shoulder to stabilize while the other hand is placed on the patientís elbow to move the arm.
Tissues Being Tested Acromioclavicular joint, acromion process, proximal end of clavicle, ligamentous structures of the acromioclavicular joint
Performing the Test The examiner passively moves the humerus across the chest by flexing the shoulder to 900 and then horizontally adducting the shoulder. As the humerus approaches full horizontal adduction, question the patient regarding pain in the acromioclavicular joint. Lightly place the fingers of your other hand over the acromioclavicular joint to palpate for crepitus and separation. Perform this test on the uninvolved shoulder and compare bilaterally.
Positive Test Pain, crepitus, or separation at the acromioclavicular joint
Interpretation The presence of pain indicates pathology of the acromioclavicular joint. This procedure compresses or impinges the acromioclavicular joint and is painful if internal derangement or instability exists.
Common errors in performing exam Failing to compare bilaterally; not palpating for separation during the test
Factors possibly resulting in misinterpretation Be sure to question the patient about the exact location of the pain as this movement stresses structures other than the acromioclavicular joint as well.
Related tests Acromioclavicular shear test
References Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA: Elsevier.
Links: http://www.nismat.org/orthocor/exam/shoulder.html, http://goaggies.cameron.edu/training/study21
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