Yergasons Test

Original Editor - Tyler Shultz

Top Contributors - Kehinde Fatola, Tyler Shultz, Rachael Lowe, Kim Jackson and Kai A. Sigel

Purpose

The Yergason's Test is used to test for biceps tendon pathology, such as bicipital tendonitis and an unstable superior labral anterior posterior (SLAP) lesion. [1]

Technique

The patient should be seated or standing in the anatomical position, with the humerus in a neutral position and the elbow in 90 degrees of flexion in a pronated position. The patient is asked to externally rotate and supinate their arm against the manual resistance of the therapist produced by wrapping the hand around the distal forearm (just above the wrist joint).[2]  Yergason's Test is considered positive if the pain is reproduced in the bicipital groove and a biceps or a SLAP lesion is suspected. If a "clicking" sensation familiar to the patient is produced during the test, damage to the transverse humeral ligament (which overlies the intertubercular sulcus) should be suspected too. [1]


[3]

Evidence

Diagnostic Test Properties for detecting biceps pathology with Yergason's Test [4]
Sensitivity   0.43
Specificity   0.79
Positive Likelihood Ratio   2.05
Negative Likelihood Ratio   0.72


Test Item Cluster: The Yergason's Test is often combined with the Speed's Test to detect bicipital tendonitis.

See test diagnostics page for explanation of statistics.

Clinical Context

The test was devised in 1931 basically for detecting bicipital tendonitis. It is however now clear that the pains may arise from tenosynovitis, tendinopathy or a SLAP lesion. It also access the ability of the transverse humeral ligament to hold the biceps tendon in the bicipital groove. The biceps tendon is associated with isolated overuse injury in youths and rotator cuff disease in the elderly. [1]

The test has been found to be more useful in diagnosing SLAP lesions than biceps diseases.

Variations

A common variation of the test is described as the patient moving the shoulder into external rotation while simultaneously moving the forearm into the supine position too against resistance. It is a complex movement and the patient is encouraged to perform it without resistance first so as to be able to elicit effective response when resistance is added.

Clinical Tip

After the elbow might have been stabilized between the waists of the therapist and the patient, the free hand can palpate over the intertubercular sulcus (bicipital groove) to detect any unusual subluxation, 'clicking' or 'snapping' during the test.

Related Tests

The following are related to Yergason's test; [1]

  • Lippman's test
  • Gilchrest's sign
  • Heuter's sign
  • Ludington's test

References

  1. 1.0 1.1 1.2 1.3 Hattam P, Smeatham A. Special Tests in Musculoskeletal Examination. Edinburgh: Churchill Livingstone, 2010.
  2. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  3. Physiotutors. The Yergason's Test | SLAP Lesion | Biceps Pathology. Available from: https://m.youtube.com/watch?v=_Cjahul5yuI (Last accessed 23/9/2020)
  4. Holtby, R., Razmjou, H. (2004). Accuracy of the Speed's and Yergason's test in detecting bicpes pathology and SLAP lesions: comparison with arthroscopic findings. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 20(3), 231-236