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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