User:Jmclau1/Piano Key Sign

Piano key sign is a special orthopedic test used to look for an instability of the clavicle.

Purpose
The piano key sign is used to test for instability of the acromioclavicular notch.

Procedure
The patient sits with the involved limb relaxed at the side, or stands facing the examiner.The examiner faces the patient placing one hand over affected area. Examiner applies pressure to the subject’s distal clavicle in an inferior direction. The examiner should always use a bilateral comparison when assessing the range of elevation and depression of the involved clavicle.

Results
When pressure is used to depress the clavicle into its normal resting position and subsequently watch the clavicle elevate again once the pressure is removed. This finding is indicative of the instability of the arcromioclavicular joint on the involved side. Significant clavicular elevation may also indicate coracoclavicular joint involvement.

Advere affects
If there is a notable fracture of the clavicle the examiner should not perform this special test.