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Purpose

Test for presence of costoclavicular syndrome

Technique

Patient is standing. The examiner palpates the radial pulse and then draws the patient’s shoulder down and back as the patient lifts their chest in an exaggerated “at attention” posture. A positive test is indicated by an absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome.It is also positive if the client experiences an increase of neurologic symptoms into the upper extremity on that side. This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat.[1][2][3]

Importance of Test

Patients with Vascular types of costoclavicular syndrome often describe their pain as a fullness, heaviness, clumsiness, or weakness in their arm. The patient may also have subjective complaints of swelling, either permanent or intermittent. When performing the Costoclavicular Brace Test, the examiner is placing the patient in a position that compresses the neurovascular bundle between the first rib and clavicle, thus resulting in a decrease in pulse strength. When performing this test, it is important to test the contralateral side as well to understand the patient’s normal radial pulse.[1]

References

  1. 1.01.1 The Student Physical Therapist [Internet] Available from: Magee DJ. Orthopaedic Physical Assessment. 5th ed. Canada: Elsevier; 2006
  2. NICHOLAS INSTITUTE OF SPORTS MEDICINE AND ATHLETIC TRAUMA [Internet] Available from:

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