Lateral Pivot Shift (Apprehension) Test | Posterolateral Rotatory Instability

Execution:

1. Patient is in supine lying position with about 100° of shoulder flexion and full external rotation
2. The examiner supinates the slightly flexed forearm and applies a valgus force (some authors describe axial compression to the elbow as well)
3. The examiner then carefully passively flexes the patient’s elbow

 

Positive Outcome: Patient shows apprehension at around 20-40° of elbow flexion or dislocation of radial head (dimple in the skin).

Study	Reliability	Sn	Sp	LR+	LR-
Regan et al. (2006) awake	NA	37,5	NA	NA	NA
Regan et al. (2006) anesthesized	NA	100	NA	NA	NA