Name: Acromioclavicular (AC) Joint Test-item Cluster
Uploaded: 2023-04-26T01:00:03.000Z
Duration: 6 min 31 s
Description: Are you suffering from shoulder pain? Learn how to assess the Acromioclavicular (AC) Joint through this comprehensive video on Test-item Cluster. Discover if you have AC Joint issues quickly & easily.

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https://stream.mux.com/02VS9AL1UuS00CSKZs01OwPrcxKM7yxxiwSJg8iMTNbLDs.m3u8

Are you suffering from shoulder pain? Learn how to assess the Acromioclavicular (AC) Joint through this comprehensive video on Test-item Cluster. Discover if you have AC Joint issues quickly & easily.

Introduction to AC Joint Pathology Assessment

Demonstration of O'Brien's Active Compression Test

Application of the Cross-Body Adduction Test

Conducting the Resisted Extension Test

Interpreting Test Results for Diagnostic Clarity

Conclusion and Integration of Tests into Clinical Practice

Acromioclavicular (AC) Joint Test-item Cluster

This is Brent of the Brookbush Institute and in this video we're going over the diagnostic cluster, for AC joint pathology. I'm going to have my friend Melissa step out, she's going to help me demonstrate. Now, this cluster is made up of three tests. These tests are the O'Briens active compression test, which you probably remember from the slap lesion or labral tear cluster that we taught. We then have the two commonly used AC joint tests being the crossbody or passive adduction test, as well as the resisted extension test, which we learned in a previous video, is actually resisted horizontal abduction and i know that's a little confusing, but we're going to go ahead and demonstrate these and the idea behind this cluster, is if you have two out of three or three out of three positives, you just increased your likelihood of having an accurate diagnosis. So, let's assume that Melissa walked in and she started in her subjective evaluation, here, giving me an indication that maybe she has something a little bit more than just shoulder impingement syndrome. So I started doing some other tests and let's say I get to O'Brien's active compression test. So let's review that real quick. O'Brien's active compression test, I would start with her arm in flexion. I would then turn her all the way into internal rotation and pronation. Horizontally adduct her 15 degrees and Melissa would resist a downward force. How does that feel? That hurts? Okay. So that replicates her symptoms but I'm not done here, where do you feel that? "Up top" Up top on your shoulder. Ok so she doesn't feel this in her shoulder, she feels this on top of her shoulder, which actually is more indicative of AC joint pathology, than labral pathology. We'll go ahead and finish O'Brien's test here. How does that feel? "Fine". So that's fine. Once again? "Pain". That's pain and where do you feel that? "Up top." So, she's definitely positive for O'Brien's, but the pain isn't where I would have expected, if it was a labral tear. It's on top, so already I'm thinking towards AC joint pathology, which is maybe where I would start tracking down my AC joint cluster. So, I could then follow that up with that passive adduction test. Right so, I'm gonna take her completely into horizontal adduction and give her a little over pressure. How does that feel? "Painful." That's painful too, ok, we're already two out of three, if you guys are tracking. So we're already pretty, we already have a pretty good indication, that it is AC joint. And then if I bring her to 90 degrees of flexion, 90 degrees of horizontal adduction, 90 degrees of internal rotation, and 90 degrees of elbow flexion. Right, so her elbow was lined up and level with her shoulder and then she's a right angle here with her arm, and I have her try to push out the horizontal abduction. This being her resisted extension test, we talked about that. How does that feel? "Pain". That's also pain. That's three out of three. That's a really good indication, that she has some sort of AC joint pathology that we're going to have to work on here. Now, if she had gotten, let's say one out of three tests positive and she had two negatives, what we could follow this up with, which isn't necessarily part of this cluster, is we could follow up with palpation of the AC joint. Alright so, as we just discussed, O'Brien's can be positive for both a slap lesion and AC joint pain. The cross-body test is going to hurt if you have AC joint pathology, it's also going to hurt if you have impingement syndrome. Like it's just not going to feel good to get all crammed up in here, and have all of your rotator cuff tendons and stuff impinge, all those subacromial tissues. So if I came over here and i palpated and she said that this did not hurt, alright, so how does this feel? "Fine". That feels fine. Palpation is a sensitive but not a specific test, which means it's probably good as a clearance test, as in if she gets a negative test result, there's a high likelihood that she does not have AC joint pathology. Are you guys following me with all this logic? So we have this testing cluster, that started with O'Brien's test. I did O'Brien's test and she said it hurt more over her AC joint. If I then go into my AC testing cluster, being O'Brien's cross- body and resisted extension and those are all positive, I have a good chance of it being positive. If I'm a little iffy, let's say I get a positive on O'Brien's, a positive on cross body, which are likely going to hurt with some of the other shoulder pathologies we have, but then I get a negative unresisted extension, I could then palpate and if I get a negative there too there's a good chance that we don't have AC joint pathology and maybe the complaint is more specific to her glenohumeral joint. Shall we go over that one more time? Here's what the test looks like, so, O'Brien's, flexion, right, how does this feel? "Pain" Pain, alright and then we turn over, "Nope". No pain, okay so that's a positive O'Brien's. I take her into cross-body give her a little over pressure. "Pain". That's painful, okay. Good. And then resisted extension test, push out, push towards me. "Pain." And that's pain. That's probably a pretty good indication that Melissa here, complaints are related to some sort of AC joint pathology. I hope you guys enjoyed this video. I hope you followed our logic and I hope that you'll start integrating these testing clusters into what you do in clinic, because they definitely have much higher reliability than any special test by itself. I'll look forward to seeing your comments and questions in the box below. you

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Explore reliable ACJ tests: O'Brien's, Cross-body, Resisted Extension, and palpation. Diagnose shoulder pain and ACJ injury effectively.

Acromioclavicular (AC) Joint Test-item Cluster

Acromioclavicular (AC) Joint Resisted Extension Test

Acromioclavicular (AC) Joint Cross Body Test

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