Yergasons Test

Yergason’s test is used to evaluate biceps tendon pathology, including bicipital tendinitis and superior labrum anterior to posterior (SLAP) lesions¹. Originally described in 1931, the test remains part of the standard orthopedic shoulder examination.

Test execution

Patient position

• The patient is seated or standing with the humerus in a neutral position and the elbow flexed to 90° in pronation.

Examiner position

• The examiner holds the patient’s wrist or distal forearm.

Test procedure

• The patient is instructed to actively perform shoulder external rotation while simultaneously supinating the forearm against resistance applied by the examiner².

Interpretation

• The test is considered positive if the patient experiences pain in the bicipital groove, which may indicate bicipital tendinitis or a SLAP lesion.

• A “clicking” or “snapping” sensation can indicate injury to the transverse humeral ligament¹.

Diagnostic validity and evidence

Studies report the following diagnostic properties for Yergason’s test⁴:

• Sensitivity: 43%

• Specificity: 79%

• Positive likelihood ratio (LR+): 2.05

• Negative likelihood ratio (LR–): 0.72

These values suggest that while the test is moderately specific, its sensitivity is relatively low. To improve diagnostic value, Yergason’s test is often used in combination with Speed’s test for detecting bicipital tendinitis¹.

Clinical relevance

• Yergason’s test was originally designed to identify bicipital tendinitis, but has since been found useful in detecting SLAP lesions and pathology involving the transverse humeral ligament¹.

• Clinical utility varies by patient population:

  • Younger athletes: Often associated with overuse injuries.

  • Older patients: Frequently linked to rotator cuff disease.

• The test has greater diagnostic yield for SLAP lesions compared to isolated biceps pathology.

Variations

• In a common variation, the patient performs external rotation of the shoulder and supination of the forearm against resistance simultaneously.

• It is recommended that the patient first performs the motion without resistance to learn the movement pattern before testing with resistance.

Clinical tips

• The examiner may stabilize the elbow with one hand while palpating the bicipital groove with the other hand to feel for subluxation, clicking, or snapping during the maneuver.

Related tests

Other special tests used to evaluate the biceps tendon include¹:

• Lippman’s test

• Gilchrest’s sign

• Heuter’s sign

• Ludington’s test

Conclusion

Yergason’s test is a simple and specific clinical test for biceps tendon pathology and SLAP lesions. While its sensitivity is low, it is more valuable when combined with other biceps and labral tests such as Speed’s test. Palpation of the bicipital groove during the maneuver enhances diagnostic accuracy.

Sources:

1. Hattam P, Smeatham A. Special Tests in Musculoskeletal Examination. Edinburgh: Churchill Livingstone, 2010.

2. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.

3. Clinical Physio. Yergason's Test | Clinical Physio. Available from: https://www.youtube.com/watch?v=KxuskHhckK0&ab_channel=ClinicalPhysio (Last accessed 24/09/2024).

4. Holtby R, Razmjou H. Accuracy of the Speed's and Yergason's test in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2004: 20(3):231-236.