In the Wright (hyperabduction) test, the arm is positioned how?

• A. Arms at side with palms forward
• B. Arms abducted to 90-180° with external rotation
• C. Arms overhead with elbows flexed
• D. Arms crossed in front of the chest

Answer: (B)

Testing for thoracic outlet syndrome due to compression under the pectoralis minor is done by placing the arm into extreme abduction with external rotation. In this position the arm is lifted overhead, typically toward full abduction (about 90 to 180 degrees) with the elbow extended and the forearm externally rotated. This stretches the neurovascular bundle as it passes beneath the pectoralis minor and through the thoracic outlet, making it more likely for symptoms or a diminished radial pulse to appear if compression is present. The other arm positions don’t place the same structures in a compressed path, so they’re less likely to reproduce the problem.