Which test reproduces pain, numbness, tingling, and weakness after holding the arms in position?

• A. Adson maneuver
• B. Wright test
• C. Roos stress test
• D. Costoclavicular maneuver

Answer: (C)

In thoracic outlet syndrome, symptoms from neurovascular compression often appear when the upper limb is placed in a position that narrows the outlet. The Roos stress test is designed to reproduce exactly that scenario. It asks the patient to hold the arms out to about 90 degrees of abduction with the elbows flexed and the hands open, then to repeatedly open and close the fists for about three minutes. If pain, numbness, tingling, or weakness develop in the arm during this sustained position, it indicates a positive test and supports neurovascular compression at the thoracic outlet.

This is distinct from other provocative maneuvers that rely on different movements or positions (for example, head turning with deep breath, extreme arm hyperabduction, or fixed posture with claudication-like signs), which may uncover different aspects or causes of outlet compression but don’t specifically emphasize holding the arms in that elevated, externally rotated position for several minutes.