Which test is commonly used to assess Thoracic Outlet Syndrome via provocative maneuvers?

• A. Cyriax Release Maneuver
• B. Roos Test
• C. Spurling's Test
• D. Sacral Apex Pressure Test

Answer: (B)

The test uses a provocative positioning of the upper limb to reveal compression at the thoracic outlet. The Roos maneuver places the arms in 90-degree abduction with the elbows flexed and asks the patient to repeatedly open and close the hands. This position narrows the space where the brachial plexus and subclavian vessels pass, so any neurovascular compression is more likely to produce symptoms like numbness, heaviness, pain, or pale, fatigued arms. A reproducible change in symptoms during this sustained, dynamic posture is the classic sign indicating thoracic outlet involvement.

Other tests target different areas: Spurling’s test is designed to provoke cervical nerve root compression and radicular pain, not thoracic outlet issues. Sacral Apex Pressure Test assesses the sacroiliac region rather than the upper thorax. The Cyriax Release Maneuver isn’t a standard provocative test for thoracic outlet syndrome, so it isn’t the test typically used to diagnose this condition.