Wrist SpT

Question 1

Wrist SpT

Answer 1

Scaphoid shift test
Tinel’s test
DeQuervain’s/ Finkelstein’s test
Phalen’s test

Question 2

Scaphoid shift test: procedure

Answer 2

• Position in UD and EXT
• Apply anterior force to scaphoid
• Apply a passive movement in this position to RD

Question 3

Scaphoid shift test: purpose

Answer 3

Dynamic stability of the scaphoid and a reproduction of symptoms
Scapholunate interosseous ligament instability (SLIL)

Question 4

Scaphoid shift test: SPEC/SENS

Answer 4

SENS: 47.6%
SPEC: 66.7%

Question 5

Scaphoid shift test: +ve -ve tests

Answer 5

+ P
+ audible click
- no P

Question 6

Tinel’s test: procedure

Answer 6

• Supinated hand position
• Tap over the carpal tunnel

Question 7

Tinel’s test: purpose

Answer 7

Compression neuropathy
Carpal tunnel syndrome

Question 8

Tinel’s test: SPEC/SENS

Answer 8

SENS: 25% - 75%
SPEC: 70% - 90%

Question 9

Tinel’s test: +ve -ve tests

Answer 9

+ Neural Sx
- no neural Sx

Question 10

DeQuervain’s/ Finkelstein’s test: procedure

Answer 10

• Neutral hand position
• Fingers around the thumb
• UD the wrist (Slowly)

Question 11

De Quervain’s/ Finkelstein’s test: purpose

Answer 11

De Quervain’s syndrome:
Tenosynovitis of the extensor pollicis brevis and abductor pollicis longus

Question 12

De Quervain’s/ Finkelstein’s test: SPEC/SENS

Answer 12

SENS: ???
SPEC: 100%

Question 13

De Quervain’s/ Finkelstein’s test: +ve -ve tests

Answer 13

+ increased pain in the radial stylod region and along the EPB and APL tendons
- no P or Sx

Question 14

Phalen’s test: procedure

Answer 14

• Patient to place elbows flexed on the table
• Patient asked to push the dorsal surface of their hands together and hold for 30-60 seconds

Question 15

Phalen’s test: purpose

Answer 15

Carpal tunnel syndrome

Question 16

Phalen’s test: SPEC/SENS

Answer 16

SENS: 85%
SPEC: 90%

Question 17

Phalen’s test: +ve -ve tests

Answer 17

+ Sx reproduced
+ paresthesia (Burning, tingling, numbness) in median nerve
- no P or Sx