Understanding the Costoclavicular or Military Brace or Eden’s Test Assessment
To evaluate for **Thoracic Outlet Syndrome (TOS)** caused by compression in the **costoclavicular space** (between the clavicle and the first rib).
Watch How It's Done
How do I start?
Patient is standing in a 'military attention' or exaggerated upright posture. Examiner palpates the radial pulse.
What happens?
Patient is standing. The examiner palpates the radial pulse and then draws the patient's shoulders down and back as the patient lifts their chest in an exaggerated (at attention posture). A positive test is indicated by an absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome. It is also positive if the client experiences an increase of neurologic symptoms into the upper extremity on that side. This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat
In Plain English
What Does a Positive Result Mean?
A **marked decrease or abolition of the radial pulse** or the **reproduction of the patient's neurological symptoms** (e.g., numbness, tingling).
Helpful Tip:
This test reduces the space between the clavicle and the first rib, compressing the subclavian artery/vein and brachial plexus.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other shoulder Tests
Adson's Test
To assess for Thoracic Outlet Syndrome (TOS) due to compression of the neurovascular bundle by the anterior and middle scalene muscles.
Anterior Drawer Test Of The Shoulder
To assess for anterior glenohumeral joint laxity and instability and the integrity of the anterior capsular structures.
Arm Squeeze Test
This is a new clinical test that may be useful to distinguish between Cervical radiculopathy from other shoulders related pathology. The anatomic reasoning behind this test is that because the musculocutaneous nerve (cervical root from C5 to C7), the radial nerve (from C5 to T1), the ulnar nerve (from C7 to T1), and the median nerve (from C5 to T1) are relatively superficial in the middle third of the arm and easy to elicit a painful provocation response by squeezing the arm. A moderate compression of skin, subcutis, and muscle by squeezing the middle third of the upper arm (brachial biceps and triceps area) on the side with shoulder pain elicits an intense reaction of local pain only in patients with cervical nerve root compression from C5 to T1, not when the pain arises from the shoulder.
Bear Hug Test
To assess for a tear or significant weakness in the **subscapularis tendon** (subscapularis strength).