Determine the integrity of the glenoid labrum of the shoulder and helps diagnose a labral tear.
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1. The standing patient forward flexes the arm to 90 degrees with the elbow in full extension and then adducts the arm 10 degrees to 15 degrees medial to the sagittal plane of the body and internally rotates it so that the thumb points downward.
2. The examiner, standing behind the patient, applies a uniform downward force to the arm and the patient is instructed to resist.
3. With the arm in the same position, the palm is then fully supinated and the maneuver is repeated.
4. The test is considered positive if pain is elicited during the first maneuver, and is reduced or eliminated with the second.
5. Pain localized to the acromioclavicular joint or "on top" is diagnostic of acromioclavicular joint abnormality, whereas pain or painful clicking described as "inside" the shoulder is considered indicative of labral abnormality.