According to a study done by Schlechter et al. (2009), the passive distraction test has a low sensitivity of 53% and a high specificity of 94% in the detection of superior labral tears. This means that this test has a moderate clinical value for the inclusion of superior labral tears.
To perform this test, have your patient in supine-lying position at the edge of the table. Then elevate the affected arm to 150° in the coronal plane with the elbow in extension and the forearm in supination and the upper arm stabilized to prevent humeral rotation. Then gently pronate the forearm.
This test is considered positive if the pain is reported deep inside the glenohumeral joint either anteriorly or posteriorly.
It is postulated that this maneuver rotates the radial tuberosity, placing traction on the biceps, which in turn tensions the proximal head long head of the biceps anchor at the superior labrum, causing a “peel back” or “fishing mouthing” of the labrum.
Other orthopedic tests to assess biceps pathology & SLAP lesions are:
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