Shoulder
Labral Injuries
Evidence: suggestive
Clunk Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Bankart or Labral Tears.
How to Perform
- Position: Patient supine.
- Action: Abduct arm fully overhead. Examiner places a fist behind the humeral head to push it anteriorly while rotating the humerus.
Interpretation of Results
- Positive Test: A grinding sound or 'clunk' sensation.
Diagnostic Accuracy
- Sensitivity: 44%
- Specificity: 68%
Clinical Context & Limitations
The Clunk 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 Shoulder region, combining the Clunk Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.