Wright Test

Original Editor - Rewan Elsayed Elkanafany Top Contributors - Rewan Elsayed Elkanafany and Kim Jackson

Purpose

Wright test or hyper abduction test is a provocative test  for Thoracic Outlet Syndrome  is thought to implicate the axillary interval (space posterior to pectoralis minor)[1]

Technique[1][2]

Starting Position

the test is performed in the sitting and then in a the supine positions

Procedure

the test is performed in 2steps

  1. first step:
  • head forward,while the arm is passively brought into abduction and external rotation to 90 without tilting the head.
  • The elbow is flexed no more than 45. The arm is then held for 1 min
  • the tester measure radial pulse and monitor patient symptoms onset

2. seconed step:

  • The tester monitors the patient’s symptom onset and the quality of the radial pulse.
  • The test is repeated with extremity in hyperabduction (end range of abduction) .

Positive Test

A decrease in the radial pulse and/or reproduction of the patient’s symptoms

The pulse disappearance indicates a positive test result for thoracic outlet syndrome

[3]


Evidence[1]

  • Given the numerous possible causes and symptoms associated with TOS, no single test can unequivocally establish the presence or absence of the condition, particularly where sTOS is concerned (Roos, 1982; Lindgren, 1997).
  • The classic provocation tests have been reported to be unreliable and frequently positive (up to 90%) for pulse obliteration in healthy patients (Hachulla et al., 1990; Urschel et al., 1994; Rayan and Jensen, 1995; Nannapaneni and Marks, 2003).

References

  1. 1.0 1.1 1.2 Watson LA, Pizzari T, Balster S. Thoracic outlet syndrome part 1: clinical manifestations, differentiation and treatment pathways. Manual therapy. 2009 Dec 1;14(6):586-95.
  2. Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2008.
  3. Physiotutors.Wright's Test | Thoracic Outlet Syndrome Available from:https://www.youtube.com/watch?v=L6BoVyE_vfE