A comprehensive Guide to Special Tests for Diagnosing Common Upper Extremity Injuries and Functional Disorders

✅ Introduction to special tests

In our previous blog, we introduced several special tests used to diagnose common upper extremity conditions. Now, let’s dive deeper into more special tests and their role in assessing different parts of the arm, shoulder, wrist, and hand. These tests help clinicians evaluate the range of motion, detect abnormalities, and narrow down potential diagnoses.

🧠 Special tests for shoulder injuries

Apprehension test

The Apprehension test is used to assess for anterior shoulder instability or a dislocated shoulder. The test checks whether a person feels "apprehensive" or nervous about their shoulder moving out of place.
How it’s done: The patient is positioned in a supine position, and the examiner externally rotates the shoulder while the arm is abducted.
Positive result: The patient shows signs of apprehension or discomfort.
Conditions: Anterior shoulder instability, dislocations.

Sulcus sign test

The Sulcus sign test evaluates for inferior glenohumeral instability. A positive test suggests that the shoulder joint may be unstable or that there is excessive movement.
How it’s done: The patient is seated with the arm relaxed. The clinician pulls downward on the arm to see if a "sulcus" (depression) forms below the acromion.
Positive result: A visible or palpable depression is felt below the acromion.
Conditions: Inferior shoulder instability, multidirectional instability.

Speed’s test

Speed's test is designed to detect bicep tendonitis or a rupture of the biceps tendon.
How it’s done: The patient’s arm is extended and the clinician resists the patient’s attempt to raise the arm while the forearm is supinated.
Positive result: Pain or discomfort in the biceps tendon area.
Conditions: Biceps tendonitis, biceps tendon rupture.

🦵 Special tests for elbow injuries

Tinel’s sign (Elbow)

This test is commonly used to diagnose cubital tunnel syndrome, which occurs when the ulnar nerve is compressed at the elbow.
How it’s done: The clinician taps over the ulnar nerve at the elbow.
Positive result: Tingling or a "pins and needles" sensation along the ulnar nerve distribution (typically the pinky and half of the ring finger).
Conditions: Cubital tunnel syndrome, ulnar nerve entrapment.

Cozen’s test

The Cozen’s test is used to diagnose lateral epicondylitis (tennis elbow). It helps determine if the extensor muscles of the forearm are strained or inflamed.
How it’s done: The clinician palpates the lateral epicondyle and asks the patient to extend their wrist while the clinician applies resistance.
Positive result: Pain at the lateral epicondyle.
Conditions: Tennis elbow (lateral epicondylitis).

Golfer’s elbow test

The Golfer’s elbow test is used to diagnose medial epicondylitis (golfer’s elbow).
How it’s done: The clinician palpates the medial epicondyle and then asks the patient to flex their wrist against resistance.
Positive result: Pain at the medial epicondyle.
Conditions: Golfer’s elbow (medial epicondylitis).

🤕 Special tests for wrist and hand injuries

Phalen’s test

Phalen’s test is used to diagnose carpal tunnel syndrome, which is caused by compression of the median nerve in the wrist.
How it’s done: The patient is asked to hold their wrists in full flexion for 60 seconds.
Positive result: Tingling or numbness in the thumb, index, or middle fingers.
Conditions: Carpal tunnel syndrome.

Tinel’s sign (Wrist)

Similar to Tinel’s sign at the elbow, this test is used to diagnose carpal tunnel syndrome or other nerve compressions at the wrist.
How it’s done: The clinician taps over the median nerve at the wrist.
Positive result: Tingling or a "pins and needles" sensation along the distribution of the median nerve (thumb, index, and middle fingers).
Conditions: Carpal tunnel syndrome, median nerve entrapment.

Finkelstein’s test

Finkelstein’s test helps diagnose De Quervain’s Tenosynovitis, an inflammation of the tendons on the thumb side of the wrist.
How it’s done: The patient makes a fist with the thumb inside the fingers and then tilts the wrist toward the ulnar side (inward).
Positive result: Sharp pain along the thumb and wrist.
Conditions: De Quervain’s Tenosynovitis.

Murphy’s sign

Murphy’s sign helps diagnose scaphoid fractures and other carpal bone issues.
How it’s done: The patient is asked to make a fist, and the clinician observes if the third metacarpal is aligned with the second and fourth metacarpals.
Positive result: If the third metacarpal drops or doesn’t line up, it may suggest a scaphoid fracture.
Conditions: Scaphoid fracture, carpal bone injury.

👩‍⚕️ Special tests for finger and thumb injuries

Allen’s test

The Allen’s test is used to evaluate the blood flow to the hand by testing the radial and ulnar arteries.
How it’s done: The patient is asked to make a fist and then release it while the clinician compresses the radial and ulnar arteries. The patient then opens their hand.
Positive result: If one of the arteries is blocked, the hand will stay pale or have poor blood flow.
Conditions: Arterial blockages, vascular insufficiency.

Bunnell’s test

The Bunnell’s test is used to assess for tightness in the intrinsic muscles of the hand, especially to evaluate for flexor tendon injury.
How it’s done: The clinician asks the patient to flex the PIP joint while holding the MCP joint in extension.
Positive result: If the PIP joint cannot be flexed, it may suggest a contracture or tendon issue.
Conditions: Flexor tendon injury, intrinsic muscle tightness.

---

📝 Conclusion

Special tests for the upper extremity are valuable tools in diagnosing various conditions related to the shoulder, elbow, wrist, and hand. These tests provide essential information that guides clinicians in determining the right treatment plan. However, it’s important to remember that no single test is perfect, and they should be used in combination with patient history, physical exams, and other diagnostic tools.

"This Content Sponsored by Buymote Shopping app

BuyMote E-Shopping Application is One of the Online Shopping App

Now Available on Play Store & App Store (Buymote E-Shopping)

Click Below Link and Install Application: https://buymote.shop/links/0f5993744a9213079a6b53e8

Sponsor Content: #buymote #buymoteeshopping #buymoteonline #buymoteshopping #buymoteapplication"