The O’Brien test is used to identify tears in the glenoid labrum, specifically SLAP lesions as well as acromioclavicular joint pathology.
How to Perform O’Brien Test
Position of Patient:
- Patient is sitting or standing with arm raised to 90 degrees of shoulder flexion and elbow fully extended.
- The patient adducts the arm 10 degrees and internally rotates the humerus.
- The thumb should be pointed towards the ground.
Performance: The examiner applies a downward pressure at the forearm while the patient resists. Have the patient fully supinate and repeat the procedure.
How to Interpret O’Brien Test
Positive Finding: The test is considered positive if the patient experiences pain or popping upon resistance with the arm rotated internally but no pain with the arm in neutral.
Test Accuracy / Reliability / Evidence:
O’Brien’s test Sensitivity and Specificity
2012 Metaanalysis
Sensitivity = 0.16
Specificity = 0.90
+LR = 1.6
– LR = 0.93
Source: Alqunaee M, Galvin R, and Fahey T: Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis. Arch Phys Med Rehabil 2012; 93: pp. 229-236
The O’Brien test is used to identify tears in the glenoid labrum, specifically SLAP lesions as well as acromioclavicular joint pathology.
To perform the O’Brien test the patient may be sitting or standing with arm raised to 90 degrees of shoulder flexion and elbow fully extended. The patient adducts the arm 10 degrees and internally rotates the humerus. The thumb should be pointed towards the ground.
The examiner applies a downward pressure at the forearm while the patient resists. Have the patient fully supinate and repeat the procedure.
The test is considered positive if the patient experiences pain or popping upon resistance with the arm rotated internally but no pain with the arm in neutral.
