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Piano key sign is a special orthopedic test used to look for an instability of the clavicle.
Purpose
editThe piano key sign is used to test for instability of the acromioclavicular notch. [1]
Procedure
editThe patient sits with the involved limb relaxed at the side, or stands facing the examiner.The examiner faces the patient placing one hand over affected area. Examiner applies pressure to the subject’s distal clavicle in an inferior direction. The examiner should always use a bilateral comparison when assessing the range of elevation and depression of the involved clavicle.[1]
Mechanism
editResults
editWhen pressure is used to depress the clavicle into its normal resting position and subsequently watch the clavicle elevate again once the pressure is removed. This finding is indicative of the instability of the arcromioclavicular joint on the involved side. Significant clavicular elevation may also indicate coracoclavicular joint involvement.[1]
Advere affects
editIf there is a notable fracture of the clavicle the examiner should not perform this special test. [2]
History
editReferences
edit- ^ a b c Mason, E, and C Doyle. "Book Review : Special Tests for Orthopedic Examination, 3rd Ed. Jeff G. Konon, Denise L. Wiksten, Jerome A. Isear Jr, Holly Brader, Slack Inc., 2006, 374 Pages, @$22.95, Isbn 1-5564-2741-7." Physiotherapy. 95.1 (2009): 59-60. Print.
- ^ Starkey, Chad, Sara D. Brown, Jeffrey L. Ryan, Chad Starkey, and Chad Starkey. Orthopedic and Athletic Injury Examination Handbook. Philadelphia: F.A. Davis Co, 2010.
Starkey, Chad, Sara D. Brown, Jeffrey L. Ryan, Chad Starkey, and Chad Starkey. Orthopedic and Athletic Injury Examination Handbook. Philadelphia: F.A. Davis Co, 2010.
Mason, E, and C Doyle. "Book Review : Special Tests for Orthopedic Examination, 3rd Ed. Jeff G. Konon, Denise L. Wiksten, Jerome A. Isear Jr, Holly Brader, Slack Inc., 2006, 374 Pages, @$22.95, Isbn 1-5564-2741-7." Physiotherapy. 95.1 (2009): 59-60. Print.
External links
editVideos
http://www.youtube.com/watch?v=gFwXwPD1Lxw (Video will demonstrate the piano key sign special test)
http://ahn.mnsu.edu/athletictraining/spata/shouldermodule/specialtests.html (Video is under the text piano key sign0