Pain Provocation Test
The authors (Mimori et a11999) observed that when using the anterior apprehension test in athletic patients with shoulder injuries to examine glenohumeral instability some patients noted pain during the test and the severity of pain varied with the position of
the forearm. They hypothesised that this difference could be used for diagnosing superior labrum lesions in patients with throwing injuries of the shoulder.
The patient is assessed in sitting with their arm in 90-100° abduction. The arm is passively externally rotated maximally with the forearm in maximum pronation or supination.
Reported as positive when pain is provoked only in the pronated position or when pain is more severe in this position.
Mimori et al (1999) compared the results of the pain provocation test with MRA (32) and arthroscopy (15) in 32 throwing athletes.
In 22 patients detachment of the superior labrum was observed on arthrogram and all of them had positive results on the new pain provocation test. 11 of 15 patients were found to have SLAP II lesions arthroscopically and all had positive pain provocation tests. The other 4 patients did not have superior labral tears and the pain provocation test was negative.