Costoclavicular Test

A special test for thoracic outlet syndrome

Authors

Affiliations

Nathaniel Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

AKA

• Costoclavicular maneuver
• Costoclavicular test
• Military Brace Test
• Eden’s Test

• Costoclavicular test is a special test for thoracic outlet syndrome occuring at the Thoraco-coraco-pectoral gate¹.
• This test places the patient in a position that likely reduces the volume of costoclavicular space²

Technique

• Patient position: sitting straight with both arms at side (“Exaggerated military seated posture”)
• Clinician assesses radial pulse
• Ask patient to retract and depress shoulders while protruding chest
  • Hold for 60 seconds
• Clinician assesses change in radial pulse
• Assess changes in symptoms (particularly paresthesia)

Interpretation

This test has both a quantitative (change in radial pulse) and qualitative (change in symptom) measure.

Caution

Using radial pulse to conclude a positive test has been shown to produce many false positives¹

A change in patient symptoms (worsening) is considered a positive test².

References

1.

Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS. Thoracic outlet syndrome: A controversial clinical condition. Part 1: Anatomy, and clinical examination/diagnosis. The Journal of Manual & Manipulative Therapy. 2010;18(2):74-83. doi:10.1179/106698110X12640740712734

2.

Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.