Shoulder Orthopaedic Test: Paxino's Test

The Paxinos sign test is a physical examination maneuver used to assess for acromioclavicular joint pathology, specifically for separation or dislocation of the joint.

Procedure:

1. Ask the patient to sit comfortably with the affected arm relaxed at the side.
2. Stand behind the patient and grasp their elbow with one hand.
3. With your other hand, grasp the acromion (the bony prominence at the top of the shoulder).
4. Gently and smoothly pull the patient's elbow forward while keeping your other hand on the acromion.
5. Observe the patient's face for signs of pain or discomfort and ask if they experience any pain during the maneuver.
6. Release the tension slowly and carefully.
7. Repeat the test two to three times to confirm the result.
8. Document the result of the test in the patient's medical record.

During this maneuver, the patient may report pain or discomfort in the acromioclavicular joint, indicating a positive test for acromioclavicular joint pain.

References:

1. Paxinos A, Campbell B. The painful shoulder. Clin Orthop Relat Res. 1989;(246):70-76.
2. Bennell K, Wee E, Coburn S, Green S, Harris A. Accuracy of clinical tests for diagnosis of subacromial impingement syndrome: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96(3):527-538.
3. Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther. 2004;17(2):152-164.