| ☐ Ensure the patient is comfortable |
| ☐ Record the position of testing: standing/sitting |
| ☐ Place the fingers of the palpating hand along the median sternal ridge on the upper half of the sternum and the other hand on the posterior aspect of the shoulder for support |
| ☐ Note the amount of palpable sternal separation |
| ☐ Note the amount of excessive motion during upper limb and trunk movements; forced expiratory technique (huff) and or/cough |
| ☐ Eliminate other sources of “clicking” (e.g. crepitus at the other joints – sternocostal joints) |
| ☐ Correlate subjective and physical examination findings |
| ☐ Assign the best grade that matches your findings |
| ☐ Repeat all the above steps for the Manubrium, upper and lower sternum separately as there be variation in movement found at each of these regions |