Posterolateral Rotatory Drawer Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Testing for PLRI (Rotatory instability of the radius/ulna unit).
How to Perform
- Position: Patient lies supine with the arm overhead and elbow flexed 90°.
- Action: Examiner stabilizes the humerus and applies a posterior/rotatory force to the radius and ulna, attempting to subluxate them off the capitellum.
Interpretation of Results
- Positive Test: A visible skin dimple (suction sign) or apprehension/clunk indicating subluxation.
Clinical Context & Limitations
The Posterolateral Rotatory Drawer 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 Posterolateral Rotatory Drawer Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
