Execution
- 1Position the patient sitting or standing.
- 2Abduct the shoulder to 90° and add maximal shoulder internal rotation with approximately 10° shoulder flexion.
- 3Combine this with the elbow flexion test position when performing Magee’s shoulder internal rotation elbow flexion test.
- 4Hold the position for up to 5 seconds.
- 5Ask whether any cubital-tunnel-type symptom develops or is aggravated.
Positive outcome
Development or aggravation of ulnar-distribution symptoms within less than 5 seconds is positive. Magee specifically notes the shoulder internal rotation elbow flexion modification and Ochi’s short symptom-development window.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Ochi et al. (2012) | NA | 87 | 98 | 42.5 | 0.13 |
CommentMagee includes the shoulder internal rotation elbow flexion modification for cubital tunnel syndrome. Ochi’s study showed high specificity and improved sensitivity over a 5-second elbow flexion test, but the method is less common than standard elbow flexion / compression. Use it as an additional provocation when classic tests are negative or time-limited.
High Clinical Value