Lo et al. evaluated the diagnostic accuracy of the apprehension, relocation, and surprise tests for traumatic anterior shoulder instability in 46 patients with rigorously defined diagnoses, using four blinded examiners to determine sensitivity, specificity, PPV, NPV, and interobserver reliability.
When examining for anterior shoulder instability, the key rule is: apprehension — not pain. Is what makes the relocation and surprise tests meaningful; pain relief with posterior force is equally common in rotator cuff tendinosis and should not be interpreted as confirming instability.
If all three tests reproduce apprehension, you can counsel the patient with high confidence. Specificity and PPV hit 100% in this series.
Lo et al. evaluated the diagnostic accuracy of the apprehension, relocation, and surprise tests for traumatic anterior shoulder instability in 46 patients with rigorously defined diagnoses, using four blinded examiners to determine sensitivity, specificity, PPV, NPV, and interobserver reliability.
When examining for anterior shoulder instability, the key rule is: apprehension — not pain. Is what makes the relocation and surprise tests meaningful; pain relief with posterior force is equally common in rotator cuff tendinosis and should not be interpreted as confirming instability.
If all three tests reproduce apprehension, you can counsel the patient with high confidence. Specificity and PPV hit 100% in this series.