Sulcus sign

Sulcus sign is a clinical sign used in orthopedic examination of the shoulder to detect instability, particularly in cases of glenohumeral joint dislocation. It is named for the visible or palpable depression, or sulcus, that appears below the acromion when the shoulder joint is extended and externally rotated.

Procedure

The sulcus sign test is performed with the patient in a standing or sitting position. The examiner grasps the patient's elbow and applies downward traction. In a positive test, a visible or palpable depression (sulcus) appears below the acromion.

Interpretation

The presence of a sulcus sign indicates inferior instability of the glenohumeral joint. This can be due to a number of conditions, including multidirectional instability, rotator cuff tear, or glenohumeral ligament laxity. The depth of the sulcus can give an indication of the degree of instability.

Limitations

While the sulcus sign is a useful test for detecting shoulder instability, it is not definitive. Other tests, such as the apprehension test and relocation test, may also be used to confirm the diagnosis.

See also

• Shoulder examination
• Orthopedic examination
• Glenohumeral instability