Elbow Lateral Pivot-Shift Test Special Test

What is it used for?

• Diagnosing Posterolateral Rotatory Instability (PLRI).
• Assessing the Lateral Ulnar Collateral Ligament (LUCL).

How to Perform

• Position: Patient lies supine with the arm overhead.
• Action: Examiner supinates the forearm and applies a valgus force.
• Movement: Slowly flex the elbow from full extension.

Interpretation of Results

• Positive Test: At ~40° of flexion, the radial head subluxates (pops out). As flexion continues, it reduces with a visible 'clunk'.
• Note: In awake patients, apprehension is the most common sign.

Diagnostic Accuracy

• Sensitivity: 100% (Under Anesthesia) / 38% (Awake)

References

• Magee, D. J. (2021). Orthopedic Physical Assessment.