Clunk Test
Purpose
The Clunk Test is used to identify a superior anterior and posterior glenoid labral tear of the shoulder joint.
Technique
- The patient lies in supine position with affected shoulder slightly over the edge of the bed.
- 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]
- 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]
Positive Test
- Clunk or Grinding: A clunking or grinding sensation is felt or heard, indicating a possible labral tear.
- Pain: The presence of pain during the maneuver can also indicate a positive test.[2]
Significance
- Labral Tear: The test is particularly useful for identifying superior labrum anterior to posterior (SLAP) lesions.
- Instability: Helps in diagnosing shoulder instability, especially in athletes[4].[5]
Evidence
The sensitivity and specificity of the Clunk Test has been reported by only one study[6]. The study has shown Clunk Test to have a sensitivity of 0.440% and a specificity of 0.68%[6].
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References
- ↑ Wallmann HW. Overview of shoulder orthopedic special tests. Home Health Care Management & Practive. 2010;22(5):364-366.
- ↑ 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.
- ↑ Clunk Test for a Glenoid Labral Tear
- ↑ Cleland JA, Koppenhaver SL. Netter's Orthopaedic Clinical Examination: An Evidence-Based Approach. 3rd ed. Elsevier; 2015.
- ↑ Malanga GA, Mautner K. Musculoskeletal Physical Examination: An Evidence-Based Approach. 2nd ed. Elsevier; 2016.
- ↑ 6.0 6.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.