Table 1.

Maneuvers and tests for the physical examination of suspected thoracic outlet syndrome

Test/maneuver	Description of test	Thoracic outlet syndrome subtype tested
Roos’ maneuver	Have the patient abduct their arms to 90° and externally rotate the shoulder with the elbow flexed into a football goal shape. Have the patient repeatedly open and close their hands in this position. Any signs of fatigue, paresthesia, change in radial pulse, or inability to maintain the arms in that shape is considered a positive result.	Neurogenic
Tinel’s sign in posterior triangle	With the patient seated, have their arms at the side of their body. Tap the supraclavicular fossa with a reflex hammer or the index and middle fingers. If the patient reports tenderness or reproduction of symptoms, the sign is considered positive.	Neurogenic
Upper limb tension test	With the patient in a supine position, depress the shoulder and abduct the arm to 110° and flex the elbow to 90°. Laterally rotate the patient’s shoulder, extend the wrist and fingers, and then slowly extend the elbow. A reproduction of symptoms is considered a positive result.	Neurogenic
Wright’s test	With the patient seated, palpate the radial pulse and then abduct and externally rotate the shoulder to 90–100° with the elbow flexed at 90°. A change in the radial pulse is a positive result of the test.	Neurogenic, Arterial
Adson’s test	With the patient seated, palpate the radial pulse and then abduct to ~ 30° with slight extension. With the arm in this position, have the patient hyperextend their neck and turn their head toward the affected (and abducted) arm. A change in the radial pulse is a positive result of the test.	Neurogenic, Arterial