Discussion in 'Spot Diagnosis' started by neo_star, Jan 23, 2013.
Can you identify this Orthopedic Test / provocative maneuver and state it's significance.
OBrien's Test SLAP or ACJ
Answer : [FONT="]O'Brien active compression test [/FONT]
[FONT="]O'Brien active compression test [/FONT]
[FONT="]Arm in forward flexion, adducted and pronated[/FONT]
[FONT="]Downward pressure is applied on the forearm. [/FONT]
[FONT="]Pain produced in the central region is indicative of a SLAP tear.[/FONT]
[FONT="]Anteriorly located shoulder pain is suggestive of acromioclavicular joint pathology.[/FONT]
[FONT="]The arm should also be supinated and again, downward pressure applied. The pain should be eliminated or significantly reduced compared to when the arm is pronated.[/FONT]
mechanism - when the arm [FONT="]is in forward flexion, adducted and pronated[/FONT] + pressure --> it puts the biceps at length and tugs on the slap tear reproducing the pain. Needless to say that this is just one of the countless tests available for SLAP tear and the more number of tests that are positive the more likely the diagnosis.
[FONT="]Several mechanisms of injury have been postulated, including compression, avulsion, traction, shear, and chronic degenerative changes.[/FONT]
[FONT="]The most common mechanisms of injury are extrinsic from traction to the upper extremity or intrinsic during the throwing motion, which likewise produces traction on the biceps anchor. [/FONT]
[FONT="]A third mechanism of injury proposed by Burkhart and Morgan is torsional peel-back of the posterior superior labrum during the cocking phase of throwing.[/FONT]
[FONT="]Compression, shear, and degenerative changes associated with decreased peripheral vascularity and age increase the likelihood of labral tears.[/FONT]
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