The pain was continuous, bilateral, progressive, and worse when the patient lay on his sides and during hyperabduction
of the arms, radiating to the shoulders.
Adson's test for TOS was positive with loss of radial pulse and numbness in the left arm and hand, and Wright's hyperabduction
test was negative.
Sachatello was the first to suggest a role for the axillary arch muscle in the hyperabduction
syndrome; reported a patient with high-grade intermittent obstruction of the axillary vein due to the anomalous AAM.
also observed changes in the position of the brachial plexus fascicles and explained this finding by the fact that vascular and nervous structures are surrounded by adipose tissue, which accompany the hyperabduction
movements of the upper limb in relation to the chest.
TABLE 1 Physical examination maneuvers for Paget-Schroetter syndrome (5, 6) Test The maneuver (Done in an effort to reproduce the symptoms/attenuate the brachial or radial pulse) Wright's test The physician externally rotates and (hyperabduction
abducts the affected arm 180 degrees, maneuver) with the elbow flexed 90 degrees, as the patient inhales deeply.
The most common collateral ligament injury in the hand involves the ulnar collateral ligament of the thumb, usually due to a violent hyperabduction
mechanism and commonly referred to as "gamekeepers" or "skiers" thumb (Figure 12).
This is the 15-letter plural of the noun HYPERABDUCTION
, more of which later in this article.
(16) Motions such as repetitive hip hyperabduction
and lumbar hyperextension, a movement commonly seen in sports, can induce sheering at the pubic symphysis and may lead to a tear or series of microtears of the rectus abdominis muscle or tendon as it inserts onto the pubis.
External rotation greater than 90[degrees] at the side is suggestive of anterior ligamentous hyperlaxity; asymmetrical hyperabduction
of more than 20[degrees] compared to the contralateral arm is indicative of a stretched inferior glenohumeral ligament.
Out of 28 patients who had abnormal Doppler study (subclavian vessel compression), only 2 confirmed to have delay in flow on subclavian vessels on hyperabduction
during postoperative follow-up.
The instability exam should be completed with Gagey hyperabduction
testing , where a substantial increase in abduction on the affected side can be indicative of injury to the inferior glenohumeral ligament complex.
test: an assessment of the laxity of the inferior glenohumeral ligament.