Roos Test

The most informative responses are reproduction of the patient’s familiar pain or numbness, together with a sense of arm heaviness or unusually marked fatigue. These findings matter more when they resemble symptoms described in the clinical history. General discomfort or effort alone provides less specific information, so the clinician interprets the response in its broader examination context.

A positive response indicates that the maneuver provoked symptoms under the test conditions, but it does not identify a unique cause. Pain, sensory changes, heaviness, or fatigue may occur without proving thoracic outlet syndrome. For that reason, clinicians combine the result with the patient’s history and other examinations before deciding how strongly it supports the suspected condition.

The maneuver places the shoulders and elbows in fixed elevated positions while repeated hand opening and closing increases the physical demand on the upper limb. This challenges the nerves and blood vessels traveling between the neck and arm. Reproduction of neurovascular-type symptoms during that challenge can support concern about compression, although it cannot establish the precise cause.

Timing helps the clinician relate symptoms to the imposed challenge. A response that develops during the repeated hand movements, particularly when it reproduces familiar numbness, pain, heaviness, or pronounced fatigue, is recorded as part of the examination. The duration alone does not determine the diagnosis, because the result still requires comparison with history and other findings.

The patient holds both shoulders abducted to 90 degrees and bends both elbows to 90 degrees. While maintaining that posture, the patient repeatedly opens and closes the hands, typically for up to three minutes. The clinician observes whether the maneuver reproduces relevant symptoms or marked fatigue, rather than treating completion or noncompletion as a diagnosis by itself.

The result should be treated as one examination finding within an evaluation for possible thoracic outlet syndrome. Clinicians compare the provoked symptoms with the reported history and findings from other examinations. This approach prevents a positive response from being overinterpreted and allows the maneuver to contribute supportive evidence without serving as the sole basis for diagnosis.