Valgus Instability Stress Test | Medial Collateral Ligament Tear

Execution:

  1. Patient is in standing position
  2. The examiner externally rotates the shoulder and fixates the upper arm from the outside, while palpating the ulnar/medial collateral ligament
  3. The examiner grabs the wrist from the inside and flexes the elbow to 20-30°
  4. At last, the examiner applies an abduction / valgus force

 

Positive Outcome: Increased laxity (compared to the other side) and pain reproduction

Study Reliability Sn Sp LR+ LR-
O’Driscoll et al. (2005): Pain NA 65 50 1.3 0.7
O’Driscoll et al. (2005): Laxity NA 19 100 ∞ 0.81
Comment: The test should be rated on laxity to include and confirm medial collateral instability