Adson's test for thoracic outlet syndrome (TOS) tests for neurovascular (NV) impingement, therefore, only relying on a diminished radial pulse (i.e. a vascular symptom) misses 50% of the reason for doing it. Also, studies have shown that relying on a diminished radial pulse as positive diagnosis is flawed, as even healthy individuals will show diminished radial pulse, thus giving you a false positive. If symptoms are reproduced, either neurological or vascular, then you have a positive.
Adson's also has 3 main components as there are 3 possible areas of impingement causing TOS. Performing all three will aid in localisation of the dysfunction.
1. Supraclavicular impingement: Subclavian artery & Brachial plexus pass between heads of Scalenus Med & Ant. Turning head to affected side & then extending neck will cause these muscles to contract & cause compression.
2. Costoclavicular Impingement. The NV bundle passes between rib 1 & clavicle. Downward traction of affected arm will cause the bundle to be pulled down further over 1st rib thus causing symptoms.
3. Infraclavicular Impingement. The NV bundle passes under the coracoid process, pectoralis minor & the costocoarcoid membrane. Therefore, passive abduction, external rotation & extension of the arm will tense the above structures & cause symptoms.
Remember to hold each of these for at least 30 seconds to reproduce symptoms.
Vascular symptoms can also be reproduced by bilateral abduction & external rotation. Get patient to quickly, repetitively flex the fingers. Pain in the forearms & inability to maintain abduction will follow in the affected arm within second. Healthy individuals should be able to maintain this activity for more than a minute.
Always be aware of that symptoms could be caused by possible atherosclerosis or an apical lung tumour compressing the NV bundle.
The original Adson's test was done with the hands on the thighs without the abduction extension and & external rotation. It seems most people do it this way now.
Adson's is notorious for getting false possitives, so wouldn't putting the arm in those vectors increase the likelihood of producing false possitives?
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Adson's test for thoracic outlet syndrome (TOS) tests for neurovascular (NV) impingement, therefore, only relying on a diminished radial pulse (i.e. a vascular symptom) misses 50% of the reason for doing it. Also, studies have shown that relying on a diminished radial pulse as positive diagnosis is flawed, as even healthy individuals will show diminished radial pulse, thus giving you a false positive. If symptoms are reproduced, either neurological or vascular, then you have a positive.
osteopete 1 year ago 5
Adson's also has 3 main components as there are 3 possible areas of impingement causing TOS. Performing all three will aid in localisation of the dysfunction.
osteopete 1 year ago 2
Comment removed
osteopete 1 year ago
1. Supraclavicular impingement: Subclavian artery & Brachial plexus pass between heads of Scalenus Med & Ant. Turning head to affected side & then extending neck will cause these muscles to contract & cause compression.
2. Costoclavicular Impingement. The NV bundle passes between rib 1 & clavicle. Downward traction of affected arm will cause the bundle to be pulled down further over 1st rib thus causing symptoms.
osteopete 1 year ago
3. Infraclavicular Impingement. The NV bundle passes under the coracoid process, pectoralis minor & the costocoarcoid membrane. Therefore, passive abduction, external rotation & extension of the arm will tense the above structures & cause symptoms.
Remember to hold each of these for at least 30 seconds to reproduce symptoms.
osteopete 1 year ago 3
Vascular symptoms can also be reproduced by bilateral abduction & external rotation. Get patient to quickly, repetitively flex the fingers. Pain in the forearms & inability to maintain abduction will follow in the affected arm within second. Healthy individuals should be able to maintain this activity for more than a minute.
Always be aware of that symptoms could be caused by possible atherosclerosis or an apical lung tumour compressing the NV bundle.
osteopete 1 year ago
Comment removed
osteopete 1 year ago
The original Adson's test was done with the hands on the thighs without the abduction extension and & external rotation. It seems most people do it this way now.
Adson's is notorious for getting false possitives, so wouldn't putting the arm in those vectors increase the likelihood of producing false possitives?
BlackDice572 3 years ago