Purpose of Test: Test for presence of thoracic outlet syndrome, specifically compression between the clavicle and first rib.
Test Position: Standing.
Performing the Test: Palpate the patient's radial pulse, either unilateral or bilateral. Ask the patient patient to perform an exaggerated military position (have them pull their shoulder blades down and back). A positive test is a decrease in pulse vigor.
Diagnostic Accuracy; Unknown.
Importance of Test: Patients with Vascular types of thoracic outlet syndrome often describe their pain as a fullness, heaviness, clumsiness, or weakness in their arm. The patient may also have subjective complaints of swelling, either permanent or intermittent. When performing the Costoclavicular Brace Test, the examiner is placing the patient in a position that compresses the neurovascular bundle between the first rib and clavicle, thus resulting in a decrease in pulse strength. When performing the Costoclavicular brace test, it is important to test the contralateral side as well to understand the patient's normal radial pulse.
Note: these tests should only be performed by properly trained health care practitioners.