Shoulder Center Saar
Clinical tests for shoulder instability
Examination techniques for diagnosing shoulder instability
In our practice, we offer a variety of specialized clinical tests and state-of-the-art diagnostic procedures to precisely identify the causes of shoulder instability. These examination techniques are designed to assess the stability of the shoulder joint and identify specific injuries or instability mechanisms.
Clinical examination techniques
Apprehension test:
- Objective: Detection of anterior instability.
- Procedure: The arm is abducted and externally rotated to provoke a feeling of insecurity or fear of dislocation.
Relocation test:
- Objective: Confirmation of anterior instability.
- Procedure: In the apprehension position, light pressure is applied to the humeral head to test whether the feeling of insecurity decreases.
Sulcus sign:
- Objective: To demonstrate multidirectional instability.
- Procedure: The arm is pulled downwards and a visible depression (sulcus) at the joint indicates instability.
Load-and-shift test:
- Objective: To evaluate stability in the anterior and posterior directions.
- Procedure: The humeral head is gently moved forward and backward in a neutral position.
Jerk test:
- Objective: Detection of posterior instability.
- Procedure: The arm is pushed backward in adduction and internal rotation to provoke subluxation or repositioning of the joint.
Anterior release test (surprise test):
- Objective: Diagnosis of anterior instability.
- Procedure: After stabilizing the humeral head in the apprehension position, the pressure is suddenly released to trigger symptoms of instability.
Clinical examination tests play a central role in the diagnosis of shoulder instability, as they provide valuable clues about the type and severity of the instability. However, these tests alone are often insufficient to obtain a complete picture of the situation. An accurate diagnosis and optimal treatment planning also require the use of modern imaging techniques.
Why is the Is imaging diagnostics indispensable?
The shoulder is a complex joint stabilized by both bony and soft tissue structures. While clinical tests primarily detect functional abnormalities and instabilities, the precise analysis of structural damage often remains hidden. This is where imaging diagnostics come into play:
01
Detection of bone defects:
Hill-Sachs lesions (collapses in the humeral head) or glenoid defects (loss of portions of the joint socket) are common consequences of shoulder instability. These defects can be precisely assessed with X-rays or CT scans and are crucial for choosing the appropriate treatment.
02
Assessment of soft tissue damage:
Injuries such as labral tears (e.g., Bankart or SLAP lesions) or capsular injuries often go undetected during clinical examination. An MRI provides detailed images and also reveals inflammation or fluid accumulation in the joint.
03
Planning surgical procedures:
For complex instabilities requiring surgical intervention, 3D reconstructions using CT or MRI are essential. They enable precise planning and increase the likelihood of successful surgery.
04
Dynamic real-time investigation:
Ultrasound can be used to assess dynamic processes such as the movement of tendons or the stability of the joint capsule in real time.
The combination makes the difference
While clinical tests provide basic information about the type of instability, imaging diagnosticsthe crucial information about the extent and exact cause. Only the combination of both approaches enables a holistic assessment and individually tailored treatment planning.
In our practice, we place great emphasis on combining both elements to ensure the best possible care for our patients. Trust our expertise – for precise diagnosis and successful treatment of your shoulder problems.