Flip a coin or not Upper extremity

Question 1

Sharp-Purser Test

Answer 1

Tests for upper cervical instability
Sensitivity = .69 (meh)
Specificity = .96 (great for ruling in)

Question 2

Cervical Rotation Lateral Flexion Test

Answer 2

Tests for restrictions of 1st rib
I? O? NO?
No stats

Question 3

Spurlings Test

Answer 3

Tests for Cervical Radiculopathy
I would use it
Sensitivity = .95
Specificity .94
Both great

Question 4

Cervical Distraction Test

Answer 4

Tests for Cervical Radiculopathy
Great to rule in, not to rule out
Sensitivity = .44
Specificity = .90

Question 5

Upper Limb Tension Tests

Answer 5

Tests for Cervical Radic
Great for ruling out = Sensitivity = .97
Spin only .22 (sucks)

Question 6

Ulnar Nerve Compression Test

Answer 6

Tests for presence of cubital tunnel syndrome
It’s purdy good
Sens = .89
Spec = .98

Question 7

Elbow Extension Test

Answer 7

Tests for presence of either a bony fracture or elbow joint effusion
Can rule out a fracture pretty accurately, Sens = .91
Can’t rule it in though, better refer to find out Spec =.7

Question 8

Varus Stress Test

Answer 8

Tests for presence of a LCL tear in elbow

Stats unknown

Question 9

Valgus Stress Test

Answer 9

Tests for MCL tear in elbow

Stats unknown

Question 10

Moving Valgus Stress Test

Answer 10

Tests for presence of MCL tear in elbow
Great to rule out Sens = 1.00?
Specificity = .75

Question 11

Lateral Epicondylalgia Test Item Cluster:

Answer 11

Pain during palpation
Pain with resisted wrist extension
Pain with resisted middle finger extension
No stats

Question 12

Active Compression Test

Answer 12

Tests for presence of an AC lesion or labral tear
Not the greatest stats
Sens AC = .41; SLAP = .67 (cant rule either out)
Spin AC = .95; SLAP = .37 (Can rule in AC)

Question 13

Test Item Cluster: Impingement Syndrome

Answer 13

Hawkins-Kennedy 
Painful Arc
Infraspinatus Muscle Test
Great test if all 3 are positive LR+=10.56
2 positive LR+=5.03

Question 14

Apprehension Test

Answer 14

Tests integrity of anterior GH joint capsule and assess GH instability
Better Flip a Coin
Sens = .62
Spin = .42

Question 15

Biceps Load Test II

Answer 15

Tests for superior glenohumeral labral tear
Even Doc Z might use it
Snout = .90
Spin = .97

Question 16

Test Item Cluster: Full-Thickness Rotator Cuff Tear

Answer 16

Drop-arm sign
Painful Arc (60-120 degrees)
Infraspinatus test
I’d say there’s a good chance to have it if all 3 are positive LR+ = 15.6
WAIT! it gets better. If over 60 y/o LR+ is 28

Question 17

Axial Loading of the Thumb

Answer 17

Tests for scaphoid fracture
Would you use it?
SPIN and SNOUT = .98
Yessir!

Question 18

Scaphoid Shift Test

Answer 18

Tests for scaphoid instability
Meh
Snout = .69
Spin = .66

Question 19

Finkelstein test

Answer 19

Tests for presence of DeQuervain’s tenosynovitis
Snout purdy good = .89
It hurts on everyone can’t rule it in Spin = .14

Question 20

Carpal Compression Test

Answer 20

Tests for carpal tunnel syndrome
Snout = .64
Spin = .30 (FLIP A COIN)

Question 21

Test Item Cluster: Carpal Tunnel Syndrome

Answer 21

Age >45
Shaking hands relieves symptoms
Wrist ratio >.67
Median Sensory Field 1: (decreased sensation of median nerve distribution)
Brigham and Women’s Hospital Hand Severity Scale >=1.9
All 5 positive equals .99 spin (yay)
2-3 negative tests .98 snout