Journal of Hand Surgery (British and European Volume)

 

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Journal of Hand Surgery (British and European Volume), Vol. 22, No. 6, 719-723 (1997)
DOI: 10.1016/S0266-7681(97)80432-9

Articles

The Ulnocarpal Stress Test in the Diagnosis of Ulnar-Sided Wrist Pain

R. NAKAMURA, E. HORII, T. IMAEDA, E. NAKAO, H. KATO and K. WATANABE

From the Hand Surgery Division, Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya, Japan

Correspondence: R. Nakamura MD, Hand Surgery Division, Department of Orthopaedic Surgery, Nagoya University School of Medicine, 65 Tsurumaicho, Showaku, Nagoya 466, Japan.

Forty-five patients with persistent ulnar-sided wrist pain and a positive ulnocarpal stress test were investigated by X-ray, arthrography, 99mTechnetium bone scanning, magnetic resonance imaging and wrist arthroscopy. Ulnar wrist pathology was positively identified in nine of 45 patients by X-ray, 18 of 37 by arthrography, 19 of 27 by bone scan, four of 33 by MRI, and in all 45 patients by arthroscopy. The final diagnosis was ulnocarpal abutment syndrome in 28 patients, traumatic triangular fibro-cartilage (TFC) tear in six, lunotriquetral (LT) ligament tear in five, TFC and LT ligament tear in one, wrist arthritis in four and cartilaginous free body in one. The ulnocarpal stress test is a useful provocative test, and a positive test suggests the presence of ulnar-sided wrist pathology. The test is sufficiently sensitive to warrant further investigation by arthroscopy.


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