Special Tests
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show | De Quervain Syndrome: First dorsal compartment tenosynovitis. Flex the thumb into the palm and close the fingers around the thumb, then ulnarly deviate the wrist. Positive result is pain in the first dorsal compartment.
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First CMC Grind Test | show 🗑
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show | Skier's thumb or Gamekeeper's thumb. UCL Rupture. Apply a valgus stress to the MP joint of the thumb at 0 and 30 flexion. Laxity of 30 of 40 degrees with valgus, or more than 15 degrees greater than the contralteral side is positive for rupture.
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show | aka Scaphoid shift test. Scaphoid/Lunate dissociation: Palpate the scaphoid and place wrist in ulnar deviation. Maintian pressure on the scaphoid and move the wrist into radial deivation. Positive result: clunk as the scaphoid subluxes.
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show | aka Scapholunate shear test. Scahoid/Lunate dissoaciation. In pronation, palpate the scaphoid in one hand and the lunate in the other. Then move the scaphoid on the lunate AP. Positive is pain reproduction, laxity, clicking, or crepitus.
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show | Ganglion or dorsal wrist syndrome. With the patient's wrist and MP flexed, resist long finger extension at the MP joint. Positive is pain in the 3rd and 4th extension compartments.
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show | aka lunotriquetral shear test. LT dissociation. In pronation, palpate the lunate with one hand and the pisotriquetral compex with the other, move AP. Positive result is pain reproduction, clikcin, or crepitus.
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show | distruptions of the DRUJ. With neutral rotation, palpate the soft spot between the ulnar styloid, FCU tendon, the ulnar head and the pisiform. Positive test is pain reproduction.
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show | TFCC lesion, ulnar compaction syndrome. ulnarly deviate the wrist and apply axial load throughou the wrist and ulna; move the carpals on the ulna. Positive test pain reproduction and/or crepitus
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Ulnocarpal stress test | show 🗑
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show | holding the forearm in pronation in a suspended position. Test is positive when the therapist observes a volar 'sag' and a prominent ulnar head.
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Piano Key Sign | show 🗑
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Piano Key Test | show 🗑
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show | DRUJ inflammation or arthritis. Compress the ulnar head into the sigmoid notch then combine this with pronation and supination. Positive result is pain.
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Extensor Carpi Ulnaris Subluxation Test | show 🗑
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show | Disruption of the Ulnar Intercarpal ligaments or VISI deformity). neutral pronation, apply a volar force at the capitate whil loading the wrist and ulnarly deviate. Positive test is a painful clunk.
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show | Degenerative Arthrosis. Apply dorsal pressure to the pisiform. Positive test reproduces pain.
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Bunnell-Littler Test | show 🗑
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Oblique Retinacular Ligament Test | show 🗑
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show | Test for Vascular disorders. Compress the radial and ulnar arteries; have the patient open and close the hand; ask them to hold the hand open, and release one artery. Repeat with the other artery. A positive test is when the hand does not re-vascularize.
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Froment Sign | show 🗑
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Phalen's Test | show 🗑
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show | Tests for carpal tunnel syndrome. Tap on the volar surface of the wrist over the carpal tunnel. Positive test is pain/paresthesia in the median nerve distribution.
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