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Shoulder Special Testing: Thoracic Outlet Syndrome Testing

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Shoulder Special Testing: Thoracic Outlet Syndrome Testing

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Shoulder Special Testing: Thoracic Outlet Syndrome Testing

Shoulder Special Test: Thor-axe Outlet
Picmonic
Thoracic Outlet Syndrome (TOS) is a condition marked by compression of the various vascular structures around the cervicothoracobrachial region or thoracic. Due to the fact that TOS can sometimes masquerade as other issues within the thoracic and shoulder region accurate differential diagnosis, including the use of special tests, is often needed. In general, there are two main types of TOS: vascular TOS (involving the arteries or veins) and neurogenic TOS (involving the neurological structures).
2 KEY FACTS
THORACIC OUTLET SYNDROME TESTING
Costoclavicular Syndrome Test/Eden’s Test
Costco-clavicle/Eden

For the Eden’s Test, the patient will be standing while the clinician assesses the radial pulse. The clinician will draw the patient’s shoulders down and back. The patient lifts their chest in an exaggerated “at attention” position. A positive test is indicated if there is a decrease or disappearance of the radial pulse. It is also considered positive if the patient experiences an increase in symptoms in the upper extremity of the tested side.

Wright Test
Wright-brothers

During the Wright Test, the patient will be seated with the shoulder abducted 180°, full elbow extension, and the shoulder externally rotated. The patient is instructed to take a breath, rotate, then extend the head. The radial pulse is palpated to detect changes. A positive test is indicated if the radial pulse disappears.

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