The positive sign for thoracic outlet tests is most commonly described as what?

• A. Absent or diminished radial pulse
• B. Increased radial pulse
• C. Numbness in digits only
• D. Pain in AC joint

Answer: (A)

The main idea is that thoracic outlet provocative tests look for vascular compromise in the arm. The most consistent positive sign is a diminished or absent radial pulse when the arm is placed in provocative positions that narrow the outlet (for example, elevated, abducted, or externally rotated positions). This happens because the subclavian/axillary artery can be compressed by structures like the first rib, scalene muscles, or clavicle during these maneuvers, reducing blood flow to the forearm and hand. While numbness or tingling and pain can occur, they are not as specific or objective as the observable change in the distal pulse. An increased radial pulse would not indicate compression, and pain localized to the AC joint isn’t related to thoracic outlet mechanics.