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AC Joint Provocation Cluster by Chronopoulos

Source: Physiotutors

Execution

  1. 1Perform cross-body adduction and scores it positive only for localized AC-joint pain.
  2. 2Perform AC resisted extension and scores it positive only for localized AC-joint pain.
  3. 3Perform O’Brien active compression and scores it positive for AC-joint-localized pain rather than deep shoulder pain.
  4. 4Count the cluster as positive when all three tests are positive.
  5. 5Document that the target condition is chronic isolated AC-joint lesion rather than nonspecific shoulder pain.

Positive outcome

All three tests are positive: cross-body adduction, AC resisted extension, and O’Brien / active compression with AC-localized pain. This cluster is designed to improve rule-in confidence for chronic AC-joint lesions.

Studies

StudyReliabilitySnSpLR+LR−
Chronopoulos et al. (2004)NA25978.30.77

CommentMagee’s eAppendix lists this three-test AC cluster with high specificity but low sensitivity. The LR+ is below 10 but clinically useful in the correct chronic AC-lesion context. It is poor for ruling out AC pain because many true cases will not have all three tests positive.

High Clinical Value

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