Military Brace test requires which positioning and which finding is considered positive?

• A. Palpating radial pulse; shoulders retracted into extension and abduction; neck in hyperextension; pulse absent/diminished
• B. Seated. While palpating radial pulse, retract shoulders into extension and abduction with neck in hyperextension. Positive is absent or diminished pulse
• C. Standing; shoulders abducted 90; neck neutral
• D. Supine; pulse absent

Answer: (B)

The test targets vascular involvement in thoracic outlet syndrome, specifically compression of the subclavian artery as the costoclavicular space is narrowed by posture. In the Military Brace Position, the patient sits with the shoulders depressed and retracted (pulled back and down) and the arms in a position akin to a rigid, military stance, with the neck extended. While palpating the radial pulse, the examiner holds that position. A positive result is when the radial pulse becomes absent or markedly diminished on the tested side, indicating reduced blood flow due to compression between the clavicle and first rib.

This description matches the positioning and the expected vascular response: provocative posture (shoulders back and down with neck extension) reproduced in the seated position and a diminished pulse as the sign of a positive test. Other positions either do not maximize the costoclavicular space narrowing or rely on different signs, making them less appropriate for this specific test.