Execution
- 1Perform Paxinos sign and record whether AC-region pain is absent or present.
- 2Perform Hawkins-Kennedy testing and record whether AC-region pain is absent or present.
- 3Interpret the cluster as negative when both Paxinos and Hawkins-Kennedy are negative for AC-region pain.
- 4Use the negative cluster to reduce suspicion of symptomatic AC-joint pathology.
- 5Do not treat this as a rule-in cluster when either component is positive.
Positive outcome
This is primarily a rule-out cluster: negative Paxinos and negative Hawkins-Kennedy reduce the likelihood of symptomatic AC-joint pathology. A positive version of either test is not enough to confirm AC pathology.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Krill et al. (2018) — systematic review | NA | 93.7 | NA | NA | 0.35 |
CommentThis Krill grouping is more useful for lowering suspicion than confirming AC pathology. It includes Hawkins-Kennedy, which is not AC-specific, so scoring must focus on AC-region symptom response. The LR- is helpful but not definitive.
Moderate Clinical Value