Adson's sign

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Front of right upper extremity.

Adson's sign is the loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration.

It is sometimes used as a sign of thoracic outlet syndrome (TOS).[1]

It is named after Alfred Washington Adson.[2]

Limitations, and pathophysiology of thoracic outlet syndrome[edit]

Adson's sign is no longer used as a positive diagnosis of TOS since many people without TOS will show a positive Adson's.

There is minimal evidence of interexaminer reliability.[3]

Thoracic outlet obstruction may be caused by a number of abnormalities, including degenerative or bony disorders, trauma to the cervical spine, fibromuscular bands, vascular abnormalities, and spasm of the anterior scalene muscle. Symptoms are due to compression of the brachial plexus and subclavian vasculature, and consist of complaints ranging from diffuse arm pain to a sensation of arm fatigue, frequently aggravated by carrying anything in the ipsilateral hand or doing overhead work such as window cleaning.

Process[edit]

  • The patient is placed in a sitting position, hands resting on thighs.
  • The examiner palpates both radial pulses as the patient rapidly fills the lungs by deep inspiration.
  • With breath held, the patient hyperextends the neck and turns the head toward the same (ipsilateral) side.

If the radial pulse on that side is decidedly or completely obliterated, the result is considered positive.

See also[edit]

References[edit]

  1. ^ "Medscape: Medscape Access". Emedicine.medscape.com. 2013-02-14. Retrieved 2013-10-15. 
  2. ^ Adson's manoeuvre at Who Named It?
  3. ^ Malanga GA, Landes P, Nadler SF (April 2003). "Provocative tests in cervical spine examination: historical basis and scientific analyses". Pain physician 6 (2): 199–205. PMID 16883381.