Costoclavicular Test (Military Brace): How to Check for TOS

The Costoclavicular Syndrome Test, also known as the "Military Brace Test," is a diagnostic maneuver used to assess for Thoracic Outlet Syndrome (TOS) by compressing the costoclavicular space. Click the sections below for details.

1. Purpose

The primary purpose of this test is to **test for** Thoracic Outlet Syndrome (TOS). Specifically, it assesses for compression of the subclavian artery and brachial plexus within the costoclavicular space (the space between the clavicle and the first rib).

2. How to Perform

1. The patient is positioned in sitting, in an exaggerated "military" posture.
2. The examiner locates and palpates the patient's radial pulse on the affected side.
3. The examiner instructs the patient to retract their shoulders (pull them back), depress their shoulders (pull them down), and lift their chest up.
4. The examiner passively extends and slightly abducts the patient's arm.
5. The examiner monitors the radial pulse for any changes and asks about symptoms. This position is typically held for 30-60 seconds.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating compression) is one or both of the following:

• A significant decrease in the strength of, or complete disappearance of, the radial pulse.
• A reproduction of the patient's familiar symptoms, such as numbness, tingling, or pain down the arm.

Negative Sign (Test is NEGATIVE):
A negative test is when the radial pulse is maintained and no symptoms are reproduced.