Physical Exam

Cross-body Adduction Test

also known as Scarf test

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Video coming September 2026

How to Perform

With the patient's arm flexed to 90° (raised forward), passively adduct it horizontally across the body, bringing the elbow and hand toward the opposite shoulder while you palpate the acromioclavicular joint. A positive test is pain localized over the AC joint.

How to Interpret

This test’s findings are all below your current evidence filter.

References

Chronopoulos E, Kim TK, Park HB, Ashenbrenner D, McFarland EG. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med. 2004;32(3):655-661. PMID: 15090381. doi:10.1177/0363546503261723. [Retrospective case-control (n=35 distal-clavicle-excision cases); cross-body adduction sens 77% / spec 79% / LR+ 3.67 / LR- 0.29, PPV <30%. Case-control -> Limited (§4c).] Corroborating: Cadogan A, McNair P, Laslett M, Hing W. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain. BMC Musculoskelet Disord. 2013;14:156. PMID: 23634871. PMC3646690. [Prospective primary-care cohort n=153, fluoroscopic AC-joint lidocaine-block reference; cross-body adduction and all traditional AC tests NOT associated with an 80% anaesthetic response; combinations AUC 0.507.] Krill MK, Rosas S, Kwon K, Dakkak A, Nwachukwu BU, McCormick F. A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review. Phys Sportsmed. 2018;46(1):98-104. PMID: 29210329. [SR; weighted analysis + series/parallel + decision tree; not a bivariate pool.] No qualifying bivariate/QUADAS-2 pool -> Limited (not Strong) per §2/§16; stats null (case-control point estimates without abstract CIs, contradicted by the representative cohort).
McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.