Then ask the patient to bend the wrist … Where there is loss of normal forward glide of the carpus, is due to protective spasm. ¾2) Identify, through differential diagnosis, impairments at the wrist, radiohumeral joint, distal radioulnar joint, and TFCC. Wrist/Hand • Bilateral comparison to look for asymmetry • Inspect for atrophy, joint swelling, triggering of finger • Special Tests: Tinel, Phalen, Finkelstein, CMC grind • Include exam of shoulder and elbow to determine etiology (e.g. Pseudoinstability Test. The next special test is to diagnose DeQuervain's tendonitis, which is inflammation affecting the tendons on the thumb side of the wrist. ¾3) Demonstrate and integrate manual therapy intervention techniques in the Our philosophy: Special tests are meant to help guide your physical examination, not be the main source of your information. Intrinsic Tests (Deformity) 1. Positive test = tingling worsens Function Function: test pincer grip; squeeze my fingers (C8 root); prayer sign; carry out everyday tasks e.g. SPECIAL TESTS. 2. The hand and wrist can be palpated to localize tenderness to a specific anatomic structure. There are hundreds upon thousands of Special Tests available for physical therapists. Positive test = causes pain and carpal tunnel syndrome symptoms Tinels test: tap median nerve at its course in wrist. We suggest relying primarily on your anatomy and kinesiology and then using special tests to reinforce your findings. Wrist and Hand Examination and Interpretation CAROLYN T. WADSWORTH, MS, PT* Hand rehabilitation is an area with the potential for providing orthopaedic physical therapists a challenging and rewarding practice. It is called the Finkelstein's Test. ref: Kelly and Stanley " arthroscopy of the wrist" J Hand Surg 15B: 236-242, 1990. Objectives ¾1) Describe the influence of biomechanical and anatomical structures on wrist pain. cervical radiculopathy vs. carpal tunnel syndrome) Lack of this motion is equivalent to the apprehension sign of shoulder or patellar instability. Differentiate Intrinsic contracture from forearm flexor contracture Flexing the wrist relaxes the FDS & FDP (long flexor) tendons; if patient can then flex the IPJ's, with the wrist flexed there is intrinsic tightness, if they cannot it is a Volkmann's contracture (long flexors). Wrist and Hand Special Tests. However, success in treating the patient with hand dysfunction is closely associated with the therapist's o. Phalen ’ s test: reverse prayer sign for 1min (pain/paresthesia = carpal tunnel syndrome) o. Tinel ’ s test: tap median nerve at its course in wrist (paresthesia = carpal tunnel syndrome) o Finkelstein’s test: patient adducts thumb to palm and closes fist around it, then examiner tilts wrist … Wrist/Hand Joints. 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