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Relief of pain when holding the arm above the head
57%
1275/2224
Reproduction of pain with tilting head to affected side and rotating head to contralateral side
38%
849/2224
Compensatory inter-phalangeal joint flexion of the thumb when attempting to pinch
2%
55/2224
Patient is unable to make "AOK" sign with index finger and thumb
1%
18/2224
Forearm pain with resisted wrist extension
0%
10/2224
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Relief of pain when holding the arm above the head is indicative of a cervical radiculopathy instead of a peripheral neuropathy. Davidson et al found that in 22 patients requiring myelography for unremitting radicular pain, 15 experienced relief of pain with shoulder abduction. Of the 15 with this physical exam finding, 13 patients achieved a good result with cervical surgery. In conclusion, they argue this exam finding has value as an indicator for cervical radicular compressive disease and postulate that the maneuver seems to occur by decreasing tension on the nerve root. Incorrect Answers: Answer 2: Reproduction of pain with tilting head to the affected side and rotating head to the ipsilateral (not contralateral) side is called the Spurling's sign and also indicates cervical pathology. Answer 3: Compensatory inter-phalangeal joint flexion of the thumb when attempting to pinch (Froment's sign) is seen with a peripheral ulnar neuropathy. Answer 4: Inability to make an "A-OK" sign with index finger and thumb is seen with a peripheral AIN compressive neuropathy. Answer 5: Forearm pain with resisted wrist extension is seen with lateral epicondylitis (tennis elbow).
2.7
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