A positive apprehension test most strongly suggests which condition?

• A. Anterior shoulder instability or labral tear
• B. Posterior shoulder dislocation
• C. AC joint arthritis
• D. Medial epicondylitis

Answer: (A)

The test is about anterior shoulder stability. A positive apprehension sign means the patient becomes fearful or uneasy that the shoulder will dislocate when the arm is placed in abduction with external rotation. This reproduces the feeling of instability in the front of the shoulder and points to injuries that compromise the glenohumeral joint’s anterior restraint, such as anterior dislocation and associated labral (Bankart) tears. That’s why the strongest implication is anterior shoulder instability or a labral tear.

Posterior dislocation would be signaled by signs of instability or pain with posterior directions, not the classic anterior apprehension. AC joint arthritis presents with pain localized to the AC joint, especially with cross-body adduction, rather than an instability-indicating apprehension. Medial epicondylitis causes elbow pain with resisted wrist flexion and palpation of the medial epicondyle, not shoulder instability signs.