Understanding Special Tests for Arms

The Empty Can Test evaluates the supraspinatus muscle and checks for shoulder impingement.The patient extends their arm at a thirty degree angle from their body with their thumb pointing down, similar to emptying a can.The examiner applies downward resistance while the patient tries to maintain the position. Pain indicates a positive test.Next, we'll examine Speed's Test for biceps tendonitis.The patient holds their arm straight out with the palm facing up and the shoulder flexed to ninety degrees.The examiner applies downward resistance while the patient resists. Pain in the bicipital groove indicates a positive test.Finally, we'll demonstrate Yergason's Test for biceps tendon stability.The patient's elbow is flexed to ninety degrees with the forearm pronated.The patient attempts to externally rotate their arm against resistance. Pain or a clicking sensation indicates a positive test.For Cozen's Test, position the patient's arm with the elbow extended and forearm pronated.The examiner stabilizes the elbow while the patient extends their wrist against resistance.A positive test produces pain at the lateral epicondyle, indicating lateral epicondylitis.Next, let's examine Mill's Test, which also assesses for lateral epicondylitis.The examiner passively flexes the patient's wrist while the elbow is extended and forearm pronated.Pain at the lateral epicondyle during passive stretching indicates a positive Mill's Test.Finally, we'll demonstrate Tinel's Test at the elbow for ulnar nerve assessment.The examiner taps along the cubital tunnel, following the course of the ulnar nerve.A positive Tinel's sign produces tingling or electric shock sensations along the ulnar nerve distribution.For Finkelstein's Test, we assess De Quervain's tenosynovitis by examining the first dorsal compartment tendons.First, have the patient flex their thumb across their palm and close their fingers over it.Then, passively ulnarly deviate the wrist. Pain over the radial styloid indicates a positive test.Next, we'll examine Phalen's Test and its reverse variation for carpal tunnel syndrome.In regular Phalen's, the patient fully flexes both wrists, while in reverse Phalen's, they extend them.Both tests should be held for a full sixty seconds. Numbness or tingling in the median nerve distribution indicates a positive test.The Piano Key Test assesses stability of the distal radioulnar joint.While stabilizing the radius, apply pressure to the distal ulna as if pressing a piano key.Excessive movement or pain indicates instability of the distal radioulnar joint.