Test: Schepelmann's Sign - Concave pain

Video Link

Background/Purpose

The thoracic ring requiers the proper function of multiple systems including the muscles of the chest and back, the joints (thoracic, costal, sternal) and even the viscera (pleural/lungs). Identifying an abnormal tissue can be difficult given these variables and their reliance on coupled motion. There are two assessments that are achieved with this test differentiated by pain produced on the concave or convex side. It is thought that pain on the concave side is a result of intercostal neuritis due to compression. It is thought that pain on the convex side is the result of muscle strain or possibly dry pleurisy.

Procedure

Subject is seated or standing. Subject raises arms over head and laterally bends to right to test the right side and to the left to test the left side. Pain on the concave side indicates intercostal neuritis.
Performed: Unilaterally

Dialog

Patient laterally bends with arms overhead

Criteria

• Full ROM without affect
• Pain free ROM

Measurement

0.00

LOINC Code

0

Scale/Grading

Pass/Fail