Wright Test (Hyperabduction): How to Check for TOS

The Wright Test, also known as the Hyperabduction Test, is a key diagnostic maneuver for Thoracic Outlet Syndrome (TOS). It is used to assess for compression under the pectoralis minor tendon. Click the sections below for details.

1. Purpose

The primary purpose of the Wright Test is to **test for** Thoracic Outlet Syndrome (TOS). It is designed to detect compression of the axillary artery and brachial plexus as they pass beneath the coracoid process and the pectoralis minor tendon.

2. How to Perform

1. The patient is positioned in sitting.
2. The examiner locates and palpates the patient's radial pulse on the affected side.
3. The examiner passively moves the patient's arm into hyperabduction (well beyond 90 degrees, bringing the arm overhead) and may also add external rotation.
4. The patient's head is typically kept in a neutral position.
5. The examiner monitors the radial pulse and asks for symptom reproduction. The position may be held for up to 1 minute.

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, or disappearance of, the radial pulse.
• A reproduction of the patient's familiar neurological symptoms (pain, tingling, numbness) down the arm.

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