Hi Linh,
Your technique is the same as mine,
I like the way you have conducted the examination.
The Adson’s test is a provocative manoeuvre.
With the patient sitting on a chair or the bed place the ipsilateral arm into 30 degrees of shoulder abduction with elbow extension.
Then externally rotate the shoulder slightly (pull their arm back a little).
Then ask the patient to turn their head and look towards the side being examined.
Then ask them to take a breath in and hold it.
When you scan the subclavian artery in the location you have described you will see a high grade stenosis or occlusion if it is positive.
The only think that worries me a little is that if you pull the arm back too far it can be positive in normal volunteers. So I stick to a more natural physiological range of movement that the patient would do in everyday life.
In my experience, when they are positive and symptomatic, the simple act of placing the shoulder into 90 degrees of abduction and making a stop sign posture will create a high grade stenosis or occlusion of the subclavian artery. So whenever they do anything above their head they are occluding. Not much fun if you are hanging out washing, painting a ceiling, stacking high shelves, or working under a car on a hoist as a mechanic!
Great work Linh,
Steve