Which orthopedic test is used to confirm multidirectional shoulder instability due to inferior laxity?

Which orthopedic test is used to confirm multidirectional shoulder instability due to inferior laxity?

• A. Lift Off Test
• B. Sulcus sign with Load and Shift
• C. Mazion shoulder maneuver
• D. Empty Can Test

Answer: (B)

The key idea is measuring inferior translation of the humeral head to detect multidirectional shoulder instability. The sulcus sign looks for a visible or palpable indentation below the lateral edge of the acromion when you apply downward traction on the arm. This downward pull uncovers laxity in the inferior capsule. When you add the Load and Shift component, you not only observe the sulcus but also stress the joint by translating the humeral head with an applied load, which helps reveal excessive inferior translation and multidirectional instability. This combination is most sensitive for confirming instability due to inferior laxity. Other tests focus on different issues: the Lift Off Test primarily assesses the subscapularis muscle-tendon function; the Empty Can Test screens for supraspinatus pathology; the Mazion shoulder maneuver is another laxity assessment but does not pinpoint inferior laxity as directly as the sulcus sign with Load and Shift.

The key idea is measuring inferior translation of the humeral head to detect multidirectional shoulder instability. The sulcus sign looks for a visible or palpable indentation below the lateral edge of the acromion when you apply downward traction on the arm. This downward pull uncovers laxity in the inferior capsule. When you add the Load and Shift component, you not only observe the sulcus but also stress the joint by translating the humeral head with an applied load, which helps reveal excessive inferior translation and multidirectional instability. This combination is most sensitive for confirming instability due to inferior laxity.

Other tests focus on different issues: the Lift Off Test primarily assesses the subscapularis muscle-tendon function; the Empty Can Test screens for supraspinatus pathology; the Mazion shoulder maneuver is another laxity assessment but does not pinpoint inferior laxity as directly as the sulcus sign with Load and Shift.