Shoulder
Thoracic Outlet
Evidence: uncertain
Halstead Maneuver Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing TOS.
How to Perform
- Position: Patient seated. Examiner palpates radial pulse.
- Action: Examiner pulls the arm downward (traction) while the patient hyperextends the neck and rotates the head to the opposite side.
Interpretation of Results
- Positive Test: Absence or diminution of pulse.
Clinical Context & Limitations
The Halstead Maneuver 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 Halstead Maneuver with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
