The Scarf Test (or Cross Arm Adduction Test, or Cross Chest Adduction Test) is a very simple test that is used in orthopedic shoulder examination as a test for acromioclavicular (a-c) joint injury / pathology. A positive test commonly indicates ac joint osteoarthritis or ac joint ligament injuries such as a ligament sprain or joint separation. The acromioclavicular joint is very prone to injury due to the small articulation surfaces that are quite incongruent. The two surfaces are the distal end of the collarbone / clavicle and the acromion process of the scapula. Injuries usually occur due to falls and in contact sports.
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Involved structures
- AC Joint (acromioclavicular joint)
Starting Position
With the arm to be tested in 90 degrees of elbow flexion and 90 degrees of shoulder flexion (forward elevation), the patient then cross adducts / horizontally adducts, resting the hand on top of the opposite shoulder.
Test Movement
The examiner pushes the arm into further cross / horizontal adduction. The position and movement mimics throwing a ‘scarf’ over the shoulder, hence the name of the test.
Positive Test
A positive test is indicated by localized pain over the acromioclavicular joint.
Video Demonstration
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