Which maneuver is used to evaluate thoracic outlet syndrome with sustained arm positions?

• A. Adson's test
• B. Roos test
• C. Wright's test
• D. EAST (Elevated Arm Stress Test)

Answer: (B)

The maneuver uses sustained arm positions to provoke thoracic outlet compression and reproduce symptoms, making it a practical test for thoracic outlet syndrome. In this approach, the arms are placed in a 90-degree abducted and externally rotated position with elbows bent, and the patient repeatedly opens and closes the fists for about three minutes. This endurance activity stresses the structures passing through the thoracic outlet (brachial plexus and subclavian vessels). If numbness, weakness, fatigue, color changes, or other vascular or neurologic symptoms appear, the test is considered positive, indicating provocative compression during sustained positions.

Other tests rely on different provocative mechanisms or single-position compression rather than sustained endurance. The Elevated Arm Stress Test is another name you might see for this same end-range, endurance-focused approach, but the essential idea remains the same: hold a provocative position long enough to reveal dynamic compression.