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This Article Full Text Full Text (PDF) All Versions of this Article: 32/8/1849    most recent 0363546504265263v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Kim, S.-H. Articles by Oh, I. Search for Related Content PubMed PubMed Citation Articles by Kim, S.-H. Articles by Oh, I. Related Collections Shoulder Nonoperative

Painful Jerk Test

A Predictor of Success in Nonoperative Treatment of Posteroinferior Instability of the Shoulder

From the Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea

^* Address correspondence to Seung-Ho Kim, MD, Department of Orthopaedic Surgery, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.

Background: The jerk test has been used as a diagnostic test of the posteroinferior instability of the shoulder. Pain may or may not be associated with posterior clunking during the jerk test.

Purpose: To evaluate the presence or absence of pain with the jerk test as a predictor of the success of nonoperative treatment for posteroinferior instability of the shoulder and to identify the pathologic lesion responsible for the pain in the jerk test.

Study Design: Retrospective review of prospectively collected data.

Methods: Eighty-one patients (89 shoulders) who had posteroinferior instability with a positive posterior clunk in their shoulders during the jerk test were nonoperatively treated. The patients were divided into 2 groups with respect to the presence of pain in the jerk test: the painless jerk group (54 shoulders) and the painful jerk group (35 shoulders). Response to the nonoperative treatment was evaluated after at least a 6-month rehabilitation program. Patients who did not respond to the rehabilitation underwent arthroscopic examination to identify any pathologic lesions.

Results: The painful jerk group had a higher failure rate with nonoperative treatment (P < .001). In the painless jerk group, 50 shoulders (93%) responded to the rehabilitation program after a mean of 4 months. Four shoulders (7%) were unresponsive to the rehabilitation. In the painful jerk group, 5 shoulders (16%) were successful with the rehabilitation, whereas the other 30 shoulders (84%) failed. All 34 shoulders that were unresponsive to the rehabilitation had a variable degree of posteroinferior labral lesions.

Conclusions: The jerk test is a hallmark for predicting the prognosis of nonoperative treatment for posteroinferior instability. Shoulders with symptomatic posteroinferior instability and a painful jerk test have posteroinferior labral lesions.

Key Words: jerk test • diagnosis • arthroscopy • posteroinferior instability • shoulder

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