A Prospective Blinded Study Evaluating the Diagnostic Accuracy of Provocative Wrist Tests

  • Ms Rosemary Prosser, Sydney Hand Therapy & rehabilitation Centre, Sydney, Australia
  • Assoc Prof Robert Herbert, George Institute, University of Sydney, Sydney, Australia
  • Dr Peter Scougall, St Lukes Hospital Hand Unit, Sydney, Australia
  • Dr Ian Hargreaves, St Lukes Hospital Hand Unit, Sydney, Australia
  • Dr Lisa Harvey, Rehabilitation Studies Unit, University of Sydney, Sydney, Australia
  • Assoc Prof Paul LaStayo, University Utad, salt Lake city, Utah, USA, United States

    • Wrist ligament lesions may be due to injury or attenuation due to repeated loading of the wrist. The diagnosis and treatment of these problems is often prolonged due to the lack of accurate diagnosis. The aim of this prospective blinded study is to estimate the diagnostic accuracy of a number of clinical wrist tests compared with the findings of MRI and arthroscopy.

    One hundred subjects with wrist pain of at least 4 weeks duration participated in the study. The clinical tests assessed included the scaphoid shift test, the lunotriquetral ballotment test, the midcarpal stress test, the TFCC stress test (UMTDG), the triquetroular critical test, the DRUJ stress test and the GRIT. The clinician carrying out the wrist tests was blinded to the MRI and arthroscope findings. The radiologist reporting on the MRI and surgeon performing the arthroscope were both blinded to the clinical examination by the therapist.

    The likelihood ratios for all the wrist tests compared to MRI and arthroscopic findings were calculated.