Feagin Test
Purpose
To check the inferior shoulder stability. Its purpose is to assesses humeral head inferior subluxation[1].
The Feagin test is also the follow-up test after the sulcus sign test with the arm abducted to 90 degree instead of being at the side[2][3] and when positive is more indicative of selective laxity of the inferior glenohumeral ligament complex.[4] If both the sulcus sign and Feagin test are positive, it is a greater indication of multidirectional instability rather than just laxity[5].[3]
Technique
- Patient position: The patient is tested best when relaxed in the sitting position beside the clinician. Patient will be in either sitting or standing position.[6]
- Examiner position: The clinician holds the patient's upper extremity at 90 degrees of abduction, with the patient's forearm over the clinician's shoulder and elbow extended[7]. [4]
- Technique: The clinician uses one hand to apply an inferiorly and slightly anteriorly directed force while the other hand palpates the edge of the acromion and the humeral head to feel for displacement anteriorly and inferiorly.
- Results: A sense of apprehension, pain, or an increased amount of translation in the inferior direction (anteroinferior instability)[3] as compared with the uninvolved side is considered a positive sign.[4]
Evidence
- Sensitivity: 0.30 (ability to correctly identify those with the condition)
- Specificity: 0.90 (ability to correctly identify those without the condition)
- Positive Likelihood Ratio (+LR): 3.0 (indicates how much the odds of the disease increase when a test is positive)
- Negative Likelihood Ratio (-LR): 0.77 (indicates how much the odds of the disease decrease when a test is negative)[8][9]
References
- ↑ Itoi E, Motzkin NE, Morrey BF, An KN. Scapular inclination and inferior stability of the shoulder. Journal of Shoulder and Elbow Surgery. 1992 May 1;1(3):131-9.
- ↑ Manske RC, Magee DJ. Orthopedic physical assessment-E-Book. Elsevier health sciences; 2020 Dec 11.
- ↑ 3.0 3.1 3.2 Magee DJ, Manske RC, Zachazewski JE, Quillen WS. Athletic and sport issues in musculoskeletal rehabilitation. Elsevier Health Sciences; 2010 Oct 21.
- ↑ 4.0 4.1 4.2 Manske RC, Stovak M. Preoperative and postsurgical musculoskeletal examination of the shoulder. Postsurgical Orthopedic Sports Rehabilitation: Knee & Shoulder. 2006:55.
- ↑ Arciero RA, Cordasco FA, Provencher MT, editors. Shoulder and Elbow Injuries in Athletes: Prevention, Treatment and Return to Sport E-Book. Elsevier Health Sciences; 2017 Oct 17.
- ↑ Iyer KM. Clinical Examination of the Shoulder (Basic and Surface Anatomy) with Special Tests. Orthopedics of the Upper and Lower Limb. 2020:3-15.
- ↑ Iyer KM. Examination of the Shoulder. InIntroduction to Limb Arthrology 2023 Mar 31 (pp. 45-139). Jenny Stanford Publishing.
- ↑ Gismervik SØ, Drogset JO, Granviken F, Rø M, Leivseth G. Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance. BMC musculoskeletal disorders. 2017 Dec;18:1-9.
- ↑ Lizzio VA, Meta F, Fidai M, Makhni EC. Clinical evaluation and physical exam findings in patients with anterior shoulder instability. Current reviews in musculoskeletal medicine. 2017 Dec;10:434-41.[1]