O’Brien’s Test is a special orthopaedic/orthopedic test for the shoulder that attempts to test specifically for glenohumeral joint labral tears (and more specifically for SLAP Lesions; superior labral tear from anterior to posterior). A false positive may occur if there is an injury to the rotator cuff or acromioclavicular joint.
- Glenoid Labrum
- acromioclavicular joint
The test is best performed with the patient in a relaxed sitting position but can also be performed in standing. The arm to be tested should be in 90 degrees of flexion and about 10 degrees of adduction. The patient then internally rotates the arm, pronating at the elbow and essentially pointing the thumb to the ground.
The examiner provides a downward force distally on the arm while the patient resists with an upward force. The examiner can also instruct the patient to simultaneously externally rotate the arm while the examiner resists this as well. The test is then repeated but with the arm in neutral rotation.
The test is considered positive if there is pain and/or clicking when the arm is in full internal rotation but not when the arm is in neutral rotation. Pain over the acromioclavicular joint (a-c joint) indicates pathology at that joint while pain felt ‘deeper’ in the shoulder is more indicative of glenoid labrum pathology. In the event of a-c joint pathology the patient will likely complain of pain in both positions of the test.
Accuracy of Test
Video Demonstration of O’Brien’s Test
video source: bigesor
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