What is the clunk test?

The clunk test is a physical examination maneuver used to assess for a labral tear in the shoulder joint.

Understanding the Clunk Test

The clunk test is a specific orthopedic test performed to identify potential tears in the glenoid labrum, a ring of cartilage that surrounds the shoulder socket (glenoid). This test is particularly useful in diagnosing SLAP (Superior Labrum Anterior to Posterior) lesions and other labral pathologies.

How it's Performed:

According to the provided reference, the clunk test is performed as follows:

1. Patient Positioning: The patient lies on their back (supine position).
2. Arm Placement: The arm being examined is moved into an externally rotated position, sometimes referred to as the "pitcher's" position.
3. Stabilization and Palpation: The examiner stabilizes the arm and places their hand underneath the humeral head (the proximal humerus).
4. Movement: The examiner then moves the arm, feeling for a "clunk" or a grinding sensation, which would indicate a potential labral tear.

Interpreting the Results

• Positive Clunk Test: A palpable clunk, click, or grinding sensation felt during the test is considered a positive result. This suggests a possible tear or injury to the glenoid labrum.
• Negative Clunk Test: The absence of a clunk or abnormal sensation is considered a negative result, indicating that a labral tear is less likely.

Why the Clunk Test Matters

• Diagnostic Tool: It's a valuable part of a comprehensive shoulder examination, helping to pinpoint specific issues like labral tears that can cause pain, instability, and reduced function.
• Treatment Guidance: A positive clunk test helps inform treatment decisions, which can range from physical therapy to surgery, depending on the severity and specifics of the injury.

Summary of the Clunk Test