Shoulder Orthopaedic Test: Scarf Test

The Scarf Test is a clinical exam used to assess the integrity of the acromioclavicular (AC) joint. It is typically performed as part of a comprehensive shoulder evaluation and can be used to diagnose AC joint injuries such as sprains or separations.

Procedure:

1. Ask the patient to sit upright and relax their arm at their side.
2. Stand behind the patient and use one hand to grasp the patient's elbow and the other hand to grasp the patient's wrist.
3. Gently lift the patient's arm and bring it across their chest towards the opposite shoulder.
4. Simultaneously compress the AC joint with the elbow.
5. Ask the patient if they experience any pain or discomfort during the maneuver.
6. Observe for any signs of pain, deformity, or instability in the AC joint.

It is important to perform the Scarf Test with caution and to avoid causing excessive pain or discomfort to the patient. If the patient experiences severe pain or discomfort during the test, it should be stopped immediately. The Scarf Test should also be performed in conjunction with other clinical tests and imaging studies to accurately diagnose and manage AC joint injuries.

References:

1. Magee, D. (2014). Orthopedic physical assessment (6th ed.). Elsevier Health Sciences. Chapter 9, pp. 394-395.
2. Hoppenfeld, S. (2012). Physical examination of the spine and extremities. Wolters Kluwer Health/Lippincott Williams & Wilkins. Chapter 15, pp. 521-522.
3. Mulligan, E. P. (2010). Manual therapy: "NAGS", "SNAGS", "MWMS", etc. (6th ed.). Plane View Services Ltd. Chapter 9, pp. 187-188.