Costoclavicular Test

The Costoclavicular Brace Test, also known as the military brace test, is a clinical assessment used to evaluate thoracic outlet syndrome, specifically costoclavicular syndrome. This condition involves compression of nerves or blood vessels in the costoclavicular interval. During the test, the examiner asks the patient to retract their shoulders and lift their chest into a military posture while monitoring the patient's radial pulse. A positive test is indicated by a weakened or absent pulse and the reproduction of symptoms, suggesting compression in the area.

The elevated arm stress test (EAST) and the costoclavicular maneuver are both used to diagnose thoracic outlet syndrome, but they assess the condition in different ways. The costoclavicular maneuver focuses on compressive forces in the costoclavicular interval, often indicated by a reduction in the patient’s radial pulse. In contrast, EAST involves repetitive arm movements with the arms raised, aiming to provoke subjective complaints such as fatigue, pain, or numbness. While both tests assess similar conditions, EAST is more dynamic, whereas the costoclavicular maneuver focuses on static positioning.

The costoclavicular maneuver is useful for diagnosing thoracic outlet syndrome, particularly costoclavicular syndrome, which occurs when nerves or blood vessels are compressed between the clavicle and the first rib. It is also used to evaluate conditions such as the presence of a cervical rib or other abnormalities causing compression. A positive result during this test, such as a reduced or absent radial pulse or reproduction of symptoms, may indicate narrowing in the costoclavicular interval. While valuable, further diagnostic tests are often needed to confirm findings and determine the best course of treatment.