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The O’Brien test is used to detect the presence of a glenoid labral tear. This test is also known as the O’Brien sign and the Active Compression test. This test is performed in two parts. In the first part, bring the patient’s shoulder to 90 degrees of flexion and adduct it horizontally by about 15 degrees. Ask the patient to internally rotate the shoulder so that the thumb points downward. Stabilize the shoulder with one hand and apply a downward pressure over the patient’s wrist and ask the patient to resist.
In the second part of the test, ask the patient to turn the palm upward and again apply a downward force to the arm while the patient resists. If the first part of the test elicits deep shoulder pain or a clicking sensation in the glenohumeral region, and the pain or click is reduced or eliminated during the second part, it is considered positive and is indicative of labral pathology. It is noteworthy that if the first and second parts of the test both produce pain in the region of the acromioclavicular joint, this is highly indicative of acromioclavicular disorder.
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