Neck Orthopaedic Test: Halstead Test

The Halstead test is a physical examination maneuver used to assess for possible thoracic outlet syndrome (TOS). It is named after Dr. Albert Halstead, who first described the test in 1934.

Procedure:

1. Instruct the patient to sit upright with their back against a wall, and their arms resting by their sides.
2. Palpate the radial pulses on both sides to establish a baseline.
3. Instruct the patient to abduct their arm to 90 degrees and then flex the elbow and bring the hand to the opposite shoulder.
4. Palpate the radial pulse on the affected side while the patient holds this position for 1 minute.
5. Release the position and recheck the radial pulses on both sides to establish the baseline again.
6. Compare the strength and presence of the radial pulses on both sides.
7. A positive test is indicated by a significant reduction or absence of the radial pulse on the affected side compared to the unaffected side.

References:

1. Freischlag JA, Orion K. Thoracic outlet syndrome: a historical perspective. Semin Vasc Surg. 2010 Mar;23(1):4-8. doi: 10.1053/j.semvascsurg.2009.11.007. PMID: 20206811.
2. Arkkila PE, Seppäläinen AM. Diagnosis and treatment of thoracic outlet syndrome. Acta Neurochir Suppl. 2007;100:85-8. doi: 10.1007/978-3-211-69370-0_17. PMID: 17985515.
3. Urschel HC Jr. Thoracic outlet syndrome. Semin Thorac Cardiovasc Surg. 1996 Oct;8(4):290-305. PMID: 8926303.