Purpose of Crank test (glenoid labral tears): To detect a labral pathology (glenoid labral tears) of the shoulder joint.
Patient position: Sitting or supine lying.
Examiner position: Stand facing the patient’s affected side.
Procedure: Abduct the patient’s arm up to 160 degrees in the scapular plane (1) and then flex the elbow joint up to 90 degrees. Apply a gentle axial load to the glenohumeral joint while internally and externally rotating the humerus (2). Make sure you stabilize the shoulder girdle (clavicle and scapula) using one hand while performing the internal and external rotation using the other hand.
To diagnose glenoid labral tears, Liu et al (3) performed internal and external rotation with an axial load along the humerus, in a position of maximum forward flexion while the patient is in supine lying.
Outcome: This test is positive if the patient experiences pain, apprehension or clicking sensation.
Reference:
- Stetson W, Templin K. The crank test, the O’Brien test, and routine magnetic resonance imaging scans in the diagnosis of Labral Tears. American Journal Of Sports Medicine. 2002;30(6):806-9.
- Liu SH, Henry MH, Nuccion SL. A prospective evaluation of a new physical examination in predicting glenoid labral tears. The American journal of sports medicine. 1996;24(6):721-5.
- Liu SH, Henry MH, Nuccion S, Shapiro MS, Dorey F. Diagnosis of glenoid labral tears: a comparison between magnetic resonance imaging and clinical examinations. The American journal of sports medicine. 1996;24(2):149-54.