Which test is used to assess AC joint pathology dynamically?

Which test is used to assess AC joint pathology dynamically?

• A. Cross-body adduction test
• B. Neer test
• C. O'Brien test
• D. Apprehension test

Answer: (A)

AC joint pathology is best revealed by a dynamic maneuver that directly loads the joint through horizontal adduction of the arm. When the patient brings the arm across the chest, the acromioclavicular joint is compressed and stressed as the distal clavicle and acromion move toward each other. If pain is reproduced at the AC joint during this cross-body/adduction movement, it strongly suggests AC joint pathology such as arthritis or a ligamentous disruption. The other tests target different shoulder structures. Neer’s test stresses the subacromial space and is more about impingement; the O’Brien test is used to screen for intra-articular pathology like SLAP lesions (and can provoke AC joint pain in some variants but isn’t the most direct dynamic AC joint stress); the apprehension test assesses glenohumeral joint stability rather than the AC joint.

AC joint pathology is best revealed by a dynamic maneuver that directly loads the joint through horizontal adduction of the arm. When the patient brings the arm across the chest, the acromioclavicular joint is compressed and stressed as the distal clavicle and acromion move toward each other. If pain is reproduced at the AC joint during this cross-body/adduction movement, it strongly suggests AC joint pathology such as arthritis or a ligamentous disruption.

The other tests target different shoulder structures. Neer’s test stresses the subacromial space and is more about impingement; the O’Brien test is used to screen for intra-articular pathology like SLAP lesions (and can provoke AC joint pain in some variants but isn’t the most direct dynamic AC joint stress); the apprehension test assesses glenohumeral joint stability rather than the AC joint.