Test: Schepelmann's Sign - Convex pain

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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.
Confimatory tests include rib motion testing, Forestiers bowstring sign, sternal compression and diagnostic imaging.

Procedure

Subject is seated or standing. Subject raises arms over head and laterally bends to right to test the left side and to the right to test the left side. Pain on the convex side muscle strain, rib sprain or possible dry pleurisy. It is important to note that for this test, laterally bending to the left tests the right side so if the tests fails with left lateral bending you are assessing the right side. Check the right side "fail" box.
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