Clunk Test: Difference between revisions
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== Purpose<br> == | == Purpose<br> == | ||
The Clunk Test is | The Clunk Test is used to identify a superior anterior and posterior glenoid labral tear of the shoulder joint.<br> | ||
== Technique< | == Technique<ref>Wallmann HW. [https://journals.sagepub.com/doi/abs/10.1177/1084822309360379?journalCode=hhcb Overview of shoulder orthopedic special tests]. Home Health Care Management & Practive. 2010;22(5):364-366.</ref><ref name=":0">Wilk KE, Reinold MM, Dugas JR, Arrigo CA, Moser MW, Andrews JR. [https://www.jospt.org/doi/10.2519/jospt.2005.35.5.273 Current concepts in the recognition and treatment of superior labral (SLAP) lesions.] ''J Orthop Sports Phys Ther''. 2005;35(5):273-291.</ref> == | ||
# The patient lies in supine position with affected shoulder slightly over the edge of the bed. | # The patient lies in supine position with affected shoulder slightly over the edge of the bed. | ||
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<clinicallyrelevant id="83906949" title="Clunk Test" /> | <clinicallyrelevant id="83906949" title="Clunk Test" /> | ||
'''Outcome''': A positive test is produced by the presence of a catch, snap, clunk, or grinding sound. It indicates a labral tear. | '''Outcome''': A positive test is produced by the presence of a catch, snap, clunk, or grinding sound. It indicates a labral tear.<ref name=":0" /> | ||
== Evidence | == Evidence<ref name=":1">Nakagawa S, Yoneda M, Hayashida K, Obata M, Fukushima S, Miyazaki Y. [https://pubmed.ncbi.nlm.nih.gov/16325078/ 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.</ref><ref>Munro W, Healy R. [https://pubmed.ncbi.nlm.nih.gov/18996735/ 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.</ref><ref>Dessaur WA, Magarey ME. [https://www.jospt.org/doi/10.2519/jospt.2008.38.6.341 Diagnostic accuracy of clinical tests for superior labral anterior posterior lesions: a systematic review.] ''J Orthop Sports Phys Ther''. 2008;38(6):341-352.</ref><ref>Hegedus EJ, Goode A, Campbell S, et al. [https://bjsm.bmj.com/content/42/2/80 Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests.] ''Br J Sports Med''. 2008;42(2):80-92.</ref> == | ||
The sensitivity and specificity of the Clunk Test has been reported by only one study<ref name=":1" />. The study has shown Clunk Test to have a sensitivity of 0.440% and a specificity of 0.68%<ref name=":1" />. | |||
Specificity (95% CI): 0.680 | * Sensitivity (95% CI): 0.440 | ||
* Specificity (95% CI): 0.680 | |||
+LR (95% CI): 1.4 | * +LR (95% CI): 1.4 | ||
* -LR (95% CI): 0.8 | |||
-LR (95% CI): 0.8 | * Accuracy (%): 57.0 | ||
Accuracy (%): 57.0 | |||
== References == | == References == | ||
<references /> | <references /> |
Revision as of 20:50, 8 February 2022
Purpose
[edit | edit source]
The Clunk Test is used to identify a superior anterior and posterior glenoid labral tear of the shoulder joint.
Technique[1][2][edit | edit source]
- 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.
- 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.
Outcome: A positive test is produced by the presence of a catch, snap, clunk, or grinding sound. It indicates a labral tear.[2]
Evidence[3][4][5][6][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]
- ↑ 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.
- ↑ 3.0 3.1 3.2 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.