Crank Test Coursework Example

Crank Test
Student’s Name Institution Affiliation Crank Test
The crank test is one of the orthopedic shoulder examinations that analyses the state of the glenoid labrum. Therefore, the analysis is done to check if there is a labral tear. Structures involved in the test include the ligaments of the glenohumeral joint and the glenol labrum.
Procedure
To carry out the test, the patient has to sit or remain in a supine position. The examiner then flexes the elbow of the patient at an angle of 90 degrees before raising the entire arm to around 180 degrees in a scapular plane. Once the hand is in the scapular position, the examiner presses the glenohumeral joint gentle hence applying a slight compressive force on the joint along the humerus axis. At the same moment, the examiner moves the humerus in the external and internal rotation. The results of the experiment are taken to be positive when the patient claims to feel pain. Also, the examiner might look of any palpable or audible sound of the joints clicks. To confirm the test to be confident with the results based on the clicks, the vibration must be heard a few times.
Accuracy of the Test
The accuracy of the crank test is quite high as stated by scientists such as Guanche et al. (2003) and Nakagawa et al. (2005). According to Guanche et al. (2003), the sensitivity of the crank test is 39% (25-56) and has a confidence interval of 95%. Its specificity is valued as 67% (48-81) with a confidence interval of 95%. The experiment done by Nakagawa (2005) indicated the crank specificity of 100% with a positive likelihood ration of 16.

1 with the range of 1.0 and 272.6. The negative likelihood ratio, on the other hand, was of 0.8 with the range of 0.6 and 1.0. According to Liu et al. (1996), the crank test sensitivity with a 95% confidence interval is 91% (76-97) and has a specificity of 93% (79-98) with the same confidence interval. The positive and negative likelihood ratio and 13.6 and 0.1 respectively.
Why It Works
According to Magee (2014), “The glenohumeral is multiaxial, ball-and-socket…depends primarily on the muscles and ligaments.” If there are any damages to the ligaments or muscle, it will be painful if pressure is applied to them or create clicking sounds if the arm is moved. As a result, the test will consistently work when used.

References
Guanche, C. A., & Jones, D. C. (2003). Clinical testing for tears of the glenoid labrum. Arthroscopy, 19(5), 11-18.
Liu, S. H., Henry, M. H., Nuccion, S., Shapiro, M. S., & Dorey, F. (1996). Diagnosis of glenoid labral tears: a comparison between magnetic resonance imaging and clinical examinations. The American journal of sports medicine, 24(2), 149-154.
Magee, D. J. (2014). Orthopedic Physical Assessment-E-Book. Elsevier Health Sciences.
Nakagawa, S., Yoneda, M., Hayashida, K., Obata, M., Fukushima, S., & Miyazaki, Y. (2005). Forced shoulder abduction and elbow flexion test: a new simple clinical test to detect superior labral injury in the throwing shoulder. Arthroscopy, 21(11), 1290-1295.