Which test primarily indicates pathology of the anterior shoulder and labrum?

• A. Clunk/Jerk Test
• B. Neer Test
• C. Hawkins-Kennedy Test
• D. Dynamic Speed's Test

Answer: (A)

The test that best points to pathology of the anterior shoulder labrum is designed to provoke the labrum itself. In the clunk/jerk maneuver, the examiner loads the humeral head and moves the arm through positions that stress the glenoid rim. If the labrum is torn, especially in the anterior–inferior region, the torn edge can catch and a palpable clunk or an audible/grinding sensation is produced as the head slides over the rim. This finding is highly indicative of labral pathology, including SLAP-type tears.

The other tests target different issues. Neer and Hawkins-Kennedy reproduce pain mainly from subacromial impingement, not labral tears, so they’re less specific for anterior labrum pathology. Dynamic Speed’s test stresses the long head of the biceps and can suggest biceps tendinopathy and sometimes SLAP lesions, but it’s not as specific for anterior labral tears as the clunk/jerk maneuver.