Shoulder: O'Brien active compression test: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Shoulder: O'Brien active compression test

Sample item

In the O'Brien test the arm is flexed to 90 degrees, adducted 15 degrees and internally rotated with the thumb down; resisted elevation causes deep pain that is relieved with the palm up. What does this suggest?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. A superior labral (SLAP) tear

Deep pain in the thumb-down position that is relieved with supination suggests a superior labrum anterior to posterior tear, because the biceps anchor is loaded when the arm is internally rotated. Pain localised to the top of the shoulder points to the acromioclavicular joint. The test is supported by MRI arthrography.

Option by option

  • A. Adhesive capsulitis

    Adhesive capsulitis limits passive external rotation.

  • B. A supraspinatus tear

    Supraspinatus tears are tested with the empty can test and drop arm sign.

  • C. Subacromial bursitis

    Bursitis causes a painful arc and not this pattern.

  • D. A superior labral (SLAP) tear (correct)

    Correct. Relief in the palm-up position suggests a SLAP lesion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, A superior labral (SLAP) tear. Deep pain in the thumb-down position that is relieved with supination suggests a superior labrum anterior to posterior tear, because the biceps anchor is loaded when the arm is internally rotated.

Why is "Adhesive capsulitis" not the answer?

Adhesive capsulitis limits passive external rotation.

Why is "A supraspinatus tear" not the answer?

Supraspinatus tears are tested with the empty can test and drop arm sign.

Why is "Subacromial bursitis" not the answer?

Bursitis causes a painful arc and not this pattern.

What concept does this question test?

It tests Shoulder: O'Brien active compression test in Orthopaedics. Pain localised to the top of the shoulder points to the acromioclavicular joint. The test is supported by MRI arthrography.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Shoulder: O'Brien active compression test?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.