Sulcus Sign – Orthopedic Shoulder Examination

The Sulcus Sign is a commonly used orthopedic examination test for inferior instability of the shoulder/glenohumeral joint. Please leave your comments or questions.

Involved Structures

  • glenohumeral joint capsule
  • ligamentous structures of the glenohumeral joint especially the superior glenohumeral ligament and the coracohumeral ligament

Starting Position

The test is usually easier with the subject in a sitting position with the arm to be tested relaxed. On the side to be tested the one of the examiner’s hands stabilizes shoulder girdle on the side to be tested. The the examiner firmly grasps the elbow of arm to be tested.

Test Movement

The examiner pulls down with the hand grasping the subject’s elbow. .

Positive Test

This test is considered positive if there is significant inferior movement of the arm relative to the shoulder and if a visible ‘sulcus’ or ‘step-off deformity’ is observed between the acromion and the humeral head. Pain and apprehension may or may not be present. A positive test is indicative of inferior or multidirectional instability (MDI).

Accuracy of Test

The accuracy of this test is considered to be very good.

Video Demonstration

 

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