Execution
- 1Position the patient seated with the test arm relaxed at the side.
- 2Stand beside the tested shoulder.
- 3Place the thumb under the posterolateral acromion.
- 4Place the index and long fingers over the middle clavicle on the same side.
- 5Apply an anterosuperior force to the acromion and an inferior counterforce to the clavicle.
Positive outcome
Increased pain in the acromioclavicular joint region is positive. The pain should be local to the AC joint rather than diffuse shoulder pain.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Walton et al. (2004) | NA | 79 | 50 | 1.58 | 0.42 |
| Krill et al. (2018) — systematic review | NA | NA | NA | NA | NA |
CommentPaxinos can be sensitive-ish in AC pain but has poor specificity as a singleton. Krill’s review uses Paxinos in pragmatic AC clusters, but the likelihood shift remains modest. Treat it as a local provocation test, not as definitive evidence.
Low Clinical Value