Provocative Physical Tests
| Diagnostic Test | Maneuver | Positive Test | Mechanism |
|---|---|---|---|
| Adson (scalene) | The patient is instructed to inspire maximally and hold his or her breath while the neck is fully extended and the head is turned toward the affected side. | The loss or decrease of radial pulse or the reproduction of neurologic symptoms suggests a positive test. | The Adson (scalene) test causes narrowing of the space between the scalenus anticus and medius, resulting in compression of the subclavian artery and the brachial plexus. |
| Halsted (costoclavicular) | The patient is instructed to place his or her shoulders in a military position (drawn backward and downward). | The loss or decrease of radial pulse or the reproduction of neurologic symptoms suggests a positive test. | The Halsted (costoclavicular) test is used to narrow the costoclavicular space between the first rib and the clavicle, thereby causing neurovascular compression |
| Wright (hyperabduction) | To perform the test, the patient’s arm is hyperabducted 180°. | The loss or decrease of radial pulse or the reproduction of neurologic symptoms suggests a positive test. | The Wright (hyperabduction) test causes the neurovascular structures to be compressed in the subcoracoid region by the pectoralis tendon, the head of the humerus, or the coracoid process and muscles/tendons arising from the process. |