Spine
Thoracic Spine
Evidence: confirmed
Chest Expansion Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Ankylosing Spondylitis (Costovertebral joint stiffness).
How to Perform
- Position: Place tape measure around the chest at the 4th intercostal space (nipple line).
- Action: Measure the difference between maximal exhalation and maximal inhalation.
Interpretation of Results
- Normal: Difference > 5cm.
- Positive: Difference < 2.5cm indicates restriction of the rib cage/thoracic spine.
Diagnostic Accuracy
- High specificity for AS.
Clinical Context & Limitations
The Chest Expansion Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Chest Expansion Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
