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Anterior Apprehension Test of the Shoulder

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Other Names

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Clinical demonstration of the apprehension test[1]
Anterior apprehension test[2]
Depiction of the seated version of the apprehension test[3]
  • Apprehension and Relocation Test
  • Anterior Apprehension Test
  • Bony Apprehension Test
  • Rowe's Apprehension Test
  • Rowe's Test

Purpose

Description

  • The patient is supine
  • Examiner flexes elbow to 90°, abducts shoulder to 90° while maintaining a neutral rotational status
  • The examiner then slowly externally rotates the shoulder at this position
  • Positive test:
    • Apprehension or guarding, not necessarily pain
    • Pain can suggest pathology other than instability
  • Note can apply "relocation" by applying a posterior force on the humeral head to reduce symptoms

Bony Apprehension Modification

  • Arm is brought to only 45 of abduction, 45 of external rotation
  • Positive Test
    • Should alert the examiner to the possibility of a bony lesion as the cause of symptomatic shoulder instability.

Seated Modification

  • Can be performed in the seated position as well

Pathology

Evidence

Need to clarify pathology

  • Flynn et al [5]
    • Sensitivity: 53%
    • Specificity: 99%
    • LR+: 53.0
    • LR-: 0.47

Bony Lesion of Anterior Glenoid

  • Skupinski et al using the 'Bony Apprehension Modification'[6]
    • Sensitivity: 100%
    • Specificity: 86%

Anterior Glenohumeral Instability

See Also

References

  1. ↑ King, Joseph J., and Thomas W. Wright. "Physical examination of the shoulder." The Journal of hand surgery 39.10 (2014): 2103-2112.
  2. ↑ Goldenberg, Brandon T., et al. "Comprehensive review of the physical exam for glenohumeral instability." The Physician and Sportsmedicine 48.2 (2020): 142-150.
  3. ↑ Tennent, T. Duncan, William R. Beach, and John F. Meyers. "A review of the special tests associated with shoulder examination: part I: the rotator cuff tests." The American journal of sports medicine 31.1 (2003): 154-160.
  4. ↑ Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am. 1981;63(6):863-872.
  5. ↑ Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
  6. ↑ Skupiński, Jarosław, et al. "The bony Bankart lesion: how to measure the glenoid bone loss." Polish Journal of Radiology 82 (2017): 58-63.
  7. ↑ Lizzio, Vincent A., et al. "Clinical evaluation and physical exam findings in patients with anterior shoulder instability." Current reviews in musculoskeletal medicine 10.4 (2017): 434-441.
Created by:
John Kiel on 9 July 2019 13:19:33
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Last edited:
2 October 2025 19:57:20
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