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Wrist Joint Special Tests: Indications and Instructions

Wrist joint special tests are diagnostic procedures used by healthcare professionals particularly orthopedic specialists and physical therapists to assess wrist injuries and disorders accurately. These tests help in identifying specific issues providing valuable insights for developing an appropriate treatment plan. In this article, we will discuss common wrist joint special tests, their indications and step by step instructions on how to perform them.

Finkelstein’s Test

Indications:

Finkelstein’s test is primarily use to diagnose De Quervain’s tenosynovitis, a condition characterized by inflammation of the tendons on the thumb side of the wrist.

How to Perform:

  1. Ask the patient to make a fist with their thumb tucked inside the fingers.
  2. Instruct the patient to bend their wrist toward their little finger.
  3. Apply gentle pressure to stabilize the forearm while the patient performs this motion.
  4. If pain or discomfort is felt on the thumb side of the wrist, the test is consider positive.

Phalen’s Test (Wrist Flexion Test)

Indications:

Phalen’s test is use to diagnose carpal tunnel syndrome, a condition characterize by compression of the median nerve in the wrist.

How to Perform:

  1. Ask the patient to flex both wrists and press the backs of their hands together forming a 90 degree angle at the wrist.
  2. Have the patient maintain this position for 1 to 2 minutes.
  3. If the patient experiences numbness, tingling or pain in the median nerve distribution (thumb, index finger, middle finger and part of the ring finger) the test is positive for carpal tunnel syndrome.

Tinel’s Sign

Indications:

Tinel’s sign is another test for carpal tunnel syndrome specifically to assess the site of nerve compression.

How to Perform:

  1. Locate the median nerve’s course by tapping or gently pressing along the wrist’s volar (palm) aspect.
  2. Begin at the distal wrist crease and move towards the proximal forearm.
  3. If the patient experiences tingling or a sensation resembling an electric shock along the median nerve distribution, the test is positive for carpal tunnel syndrome.

Watson’s Scaphoid Shift Test

Indications:

Watson’s test is use to detect scapholunate instability a condition where the scaphoid bone and lunate bone in the wrist lose their normal alignment.

How to Perform:

  1. Ask the patient to sit with the forearm pronated and the wrist flexed.
  2. Use your thumb and index finger to grip the patient’s scaphoid bone (on the thumb side of the wrist).
  3. While maintaining this grip, apply dorsal and volar-directed pressure on the scaphoid bone.
  4. Simultaneously, move the wrist from radial deviation to ulnar deviation.
  5. If a clunk or pain is felt during this maneuver, it may indicate scapholunate instability.

Conclusion

Wrist joint special tests are valuable tools in diagnosing various wrist conditions helping healthcare professionals determine the most appropriate treatment strategies. Properly conducting these tests and interpreting the results can lead to accurate diagnoses, better patient care. And improved outcomes for individuals with wrist injuries and disorders. Always ensure that these tests are perform by train healthcare providers to avoid misdiagnoses or complications.

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