The scarf test, also known as the cross-body adduction test, is a shoulder examination maneuver used to assess for pathology of the acromioclavicular (AC) joint.
How is the Scarf Test Performed?
The scarf test is performed through specific movements of the patient's arm, detailed as follows:
- Starting Position: The patient's arm is brought forward to 90 degrees of flexion at the shoulder. The elbow is also flexed at 90 degrees.
- Adduction: The examiner then horizontally adducts the patient's flexed arm across the body, moving the elbow toward the opposite (contralateral) shoulder. This movement is done passively by the examiner, meaning the patient does not actively move the arm.
- Observation: The test is considered positive if the patient experiences pain localized to the AC joint during this adduction movement.
Purpose of the Scarf Test
The primary purpose of the scarf test is to identify pathology related to the AC joint. This can include:
- AC joint arthritis: Inflammation or degeneration of the joint cartilage.
- AC joint sprains/strains: Injuries to the ligaments or muscles surrounding the joint.
- AC joint separation: A more severe injury involving a disruption of the ligaments holding the AC joint together.
Why is it called the "Scarf" Test?
The term "scarf test" comes from the arm position resembling how one might wear a scarf across their body.
Key Considerations
- A positive scarf test is suggestive of AC joint pathology, but further investigation and other tests may be needed for a definitive diagnosis.
- Pain location is crucial; pain in other areas might indicate issues other than AC joint problems.
- The test should be performed gently to avoid exacerbating any existing pain or injury.
| Element | Description |
|---|---|
| Starting Position | Shoulder flexed to 90 degrees, elbow flexed to 90 degrees. |
| Movement | Horizontal adduction of the arm across the body towards the contralateral shoulder. |
| Positive Test | Pain localized at the AC joint during adduction. |
| Purpose | To identify pathology of the AC joint (arthritis, sprains, separations). |
