Which test evaluates the lateral flexion of the first rib?

• A. Wright Test
• B. Lateral Flexion Test for the 1st Rib
• C. Adson's Test
• D. Halstead Maneuver

Answer: (B)

The idea here is to assess how the first rib moves when the neck is laterally flexed. The first rib sits at the top of the rib cage and its movement is guided by the scalene muscles and the thoracic inlet joints. In this test, the clinician palpates the first rib at the thoracic inlet while the patient side-bends the neck to the opposite side. If the first rib glides normally, mobility is good; if the rib’s motion is restricted or excessive during this lateral flexion, it indicates a first-rib dysfunction. This information helps identify a rib-level restriction as a potential contributor to neck or shoulder symptoms, guiding targeted rib mobilization or scalene muscle release.

The other tests shown are primarily used to provoke thoracic outlet compression at different structures (such as the space under the pectoralis minor or between the clavicle and first rib) and assess vascular/neurological symptoms, rather than specifically evaluating the rib’s lateral motion.