Adson's Test

Purpose of Test: Test for the presence of Thoracic Outlet syndrome, specifically compression between the Anterior and Middle Scalene Muscles.

Test Position: Standing.

Performing the Test: Palpate the radial pulse on the affected side with the elbow fully extended. Have the patient rotate their head to the side being tested and extend the neck. Next, abduct, extend, and laterally rotate the shoulder. From this position, have the patient take a deep breath and hold. Assess the pulse response. A positive test is a decrease in pulse vigor from the starting position to the final position. 

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 Adson's Test, the examiner is placing the patient in a position that compresses the subclavian artery between the anterior and middle scalene, thus resulting in a decrease in pulse strength. When performing Adson's Test, it is important to test the contralateral side as well to understand the patient's normal radial pulse. 

Note: Vascular forms of thoracic outlet syndrome are much less common than neurogenic types.

Note: these tests should only be performed by properly trained health care practitioners.