Wrist and Hand Special Tests Flashcards
Ulnar Collateral Ligament Instability Test
Lig Instability - gamekeepers or skiers thumb
hold pt’s thumb in extension and apply valgus force to the MCP joint of the thumb.
Positive = excessive valgus movement
Allen test
Radial/Ulnar artery compression
PT compresses radial and ulnar arteries at the wrist while pt clenches fist. Then PT releases pressure while pt relaxes hand and observes skin color.
Bunnel-Littler test
Contracture
MCP joint held in slight extension, PT attempts to move proximal PIP joint into flexion. Positive if joint does not move
Tight Retinacular ligament test
Contracture
PIP joint held in neutral position while therapist attempts to flex the DIP joint.
Carpal compression test
Median nerve compression
hold pt’s wrist with both hands and apply pressure over the median nerve in the carpal tunnel for 30 seconds. Also may be performed by placing wrist in 60 degrees of flexion before applying pressure.
Froment’s sign
Ulnar nerve compression
hold a piece of paper between thumb and index finger and PT attempts to pull paper away.
Positive = pt flexing the distal phalanx of the thumb due to adductor pollicis muscle paralysis.
Phalen’s test
Carpal Tunnel Syndrome
wrist in maximal flexion (upside down prayer) for 60 seconds.
Positive = tingling in thumb, index finger, middle finger, and lateral half of the ring finger.
Tinel’s sign
Carpal Tunnel Syndrome
PT taps over volar aspect of the pt’s wrist causing ingling in the thumb, index finger, middle finger and lateral half of the ring finger distal to the contact site at the wrist.
Finkelstein test
de Quervain’s disease (tenosynovitis in the thumb)
Tuck thumb inside fist and ulnarly deviate the wrist.
Positive = pain over abductor pollicis longus and extensor pollicis brevis tendons at the wrist.
Grind test
Carpometacarpal joint DJD
PT applying compression and rotation through the metacarpal joint causing pain.
Murphy sign
Dislocated lunate
Patient makes a fist.
Positive = third metacarpal remaining level with the second and fourth metacarpals
