Execution
- 1Have the patient lie supine while the examiner maintains shoulder girdle depression.
- 2Abduct the shoulder between about 10° and 90° and brings the hand toward the ear region.
- 3Position the elbow into flexion and place the wrist into extension with radial deviation.
- 4Position the shoulder in external rotation and adjusts forearm supination or pronation according to symptom response.
- 5Add contralateral cervical side flexion as a sensitising movement and compare with the opposite limb.
Positive outcome
Reproduction of the patient's familiar symptoms in an ulnar nerve or C8-T1 distribution. Symptoms should change with cervical side flexion or with unloading of the limb sequence.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Petersen & Covill (2010) | ICC 0.65 right; ICC 0.75 left | NA | NA | NA | NA |
| Kleinrensink et al. (2000) | NA | NA | NA | NA | NA |
CommentULNT4 is anatomically useful for ulnar nerve and lower cervical root bias, but diagnostic accuracy for cervical radiculopathy is sparse. Use it as part of a neurological and neurodynamic comparison rather than as a standalone diagnostic test.
Low Clinical Value