Sonographic evaluation of the axillary artery during simulated overhead throwing arm positions.
OBJECTIVE
The aim of this study was to determine changes in axillary artery diameter and peak systolic velocity in asymptomatic individuals during upper limb positioning commonly used to assess vascular pathology in athletes.


METHODS
Repeated measures observational study.


METHODS
Physiology laboratory.


METHODS
Subjective and objective screening excluded individuals with past, or present, conditions related to neurovascular compression syndromes. Thirty-one subjects (21 females, 10 males; mean age: 25+/-4 years) were included in the final analysis.


METHODS
Sonographically determined axillary artery diameter and peak systolic velocity, as well as symptom production, were recorded for a series of 12 randomised arm positions, incorporating varying degrees of abduction, external rotation, and horizontal flexion/extension.


RESULTS
The majority of arm positions revealed no change in artery diameter and peak systolic velocity. However, at the extreme of abduction, and arm positions incorporating 120 degrees abduction, significant (p<0.0005) reductions in axillary artery diameter were noted. All mean results masked wide heterogeneity: 13% demonstrating a greater than 50% reduction in diameter, 10%, a doubling of peak systolic velocity, and 42%, reporting symptoms.


CONCLUSIONS
The number of individual clinically "positive" responses questions the specificity of individual diagnostic tests, such as the hyperabduction manoeuvre, and highlights the need to interpret test results in conjunction with the subjective assessment and other physical findings from the objective assessment.
Stapleton
Claire
C
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. c.stapleton@2005.ljmu.ac.uk
Herrington
Lee
L
George
Keith
K
D000328:Adult; D001132:Arm / Q000098:blood supply*; D001366:Axillary Artery / Q000000981:diagnostic imaging* / Q000502:physiology*; D001696:Biomechanical Phenomena; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology*; D019370:Observation; D013177:Sports / Q000502:physiology*; D013647:Task Performance and Analysis; D014463:Ultrasonography; D055815:Young Adult