Allen Test for TOS

Allen Test (or Allen’s Test or Allen Maneuver or Write Test) is a common test done during the examination of the shoulder for the presence of Thoracic Outlet Syndrome (TOS). The test is easy to carry out.

Additional tests for thoracic outlet syndrome include:

Involved Structures

  • Subclavian artery
  • axillary artery
  • brachial plexus
Thoracic Outlet Diagram
Diagram of the Thoracic Outlet
BruceBlaus, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

Starting Position

The test is best performed with the patient in a relaxed sitting position. The arm to be tested should be in 90 degrees of abduction and full external rotation. The elbow should be in 90 degrees of flexion.

Test Movement

The patient rotates the head to the side opposite the arm being tested while the examiner palpates the radial pulse. The examiner can also palpate the radial pulse continuously as the patient moves from having the arm in a neutral position as the patient moves the arm and head into the end position of the test.

Positive Test

The test is considered positive if the radial pulse becomes diminished or absent after rotation of the head.

Accuracy of Test

This test is quite subjective. Accuracy is difficult to determine.

Video Demonstration

video source: PTP621 2014

>> Return to the list of Orthopedic Tests of the Shoulder

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