Clunk Test

Original Editor - Shoko Otsuka
Top Contributors - Shoko Otsuka

[edit | edit source]

The Clunk Test is used to identify a superior anterior and posterior glenoid labral tear of the shoulder joint.

Technique[edit | edit source]

  1. The patient lies in supine position with affected shoulder slightly over the edge of the bed.
  2. The examiner places one hand on the posterior aspect of the GH joint while the other hand holds the bicondylar aspect of the humerus above the elbow.[1]
  3. the examiner then fully abducts the arm over the patient's head while pushing anteriorly on the humeral head and simultaneously externally rotating the arm.[2]

Clunk Test video provided by Clinically Relevant

Outcome: A positive test is produced by the presence of a catch, snap, clunk, or grinding sound. It indicates a labral tear.[2]

Evidence[edit | edit source]

The sensitivity and specificity of the Clunk Test has been reported by only one study[3]. The study has shown Clunk Test to have a sensitivity of 0.440% and a specificity of 0.68%[3].

  • Sensitivity (95% CI): 0.440
  • Specificity (95% CI): 0.680
  • +LR (95% CI): 1.4
  • -LR (95% CI): 0.8
  • Accuracy (%): 57.0


References[edit | edit source]

  1. Wallmann HW. Overview of shoulder orthopedic special tests. Home Health Care Management & Practive. 2010;22(5):364-366.
  2. 2.0 2.1 Wilk KE, Reinold MM, Dugas JR, Arrigo CA, Moser MW, Andrews JR. Current concepts in the recognition and treatment of superior labral (SLAP) lesions. J Orthop Sports Phys Ther. 2005;35(5):273-291.
  3. 3.0 3.1 Nakagawa S, Yoneda M, Hayashida K, Obata M, Fukushima S, Miyazaki Y. Forced shoulder abduction and elbow flexion test: a new simple clinical test to detect superior labral injury in the throwing shoulder. Arthroscopy. 2005;21(11):1290-1295.
  4. Munro W, Healy R. The validity and accuracy of clinical tests used to detect labral pathology of the shoulder-a systematic review. Man Ther. 2009;14(2):119-130.
  5. Dessaur WA, Magarey ME. Diagnostic accuracy of clinical tests for superior labral anterior posterior lesions: a systematic review. J Orthop Sports Phys Ther. 2008;38(6):341-352.
  6. Hegedus EJ, Goode A, Campbell S, et al. Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. Br J Sports Med. 2008;42(2):80-92.