Elbow
Ligamentous Instability (Medial)
Evidence: confirmed
Moving Valgus Stress Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing chronic UCL tears, specifically in overhead athletes (baseball pitchers).
How to Perform
- Position: Patient stands or sits with the arm abducted to 90°.
- Action: Apply a constant valgus torque to the elbow.
- Movement: Quickly flex and extend the elbow while maintaining the stress.
Interpretation of Results
- Positive Test: Pain is reproduced specifically within the 'Shear Angle' (between 120° and 70° of flexion).
Diagnostic Accuracy
- Sensitivity: 100%
- Specificity: 75%
Clinical Context & Limitations
The Moving Valgus Stress 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 Elbow region, combining the Moving Valgus Stress Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
- Orthofixar | Moving Valgus Stress Test
