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Journal of Hand Surgery (European Volume)
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Articles

The Reliability of the "Scratch Test"

JEFFREY E. BUDOFF
JOHN M. HICKS
GUSTAVO AYALA
BARRY S. KRAUSHAAR

From the Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA, the Department of Pathology, Baylor College of Medicine, Houston, TX, USA and the Spring Valley, NY, USA

Correspondence: Jeffrey E. Budoff, MD, Department of Orthopaedic Surgery, Baylor College of Medicine, 6620 Main Street, 13th Floor, Houston, TX 77030, USA. Tel.: +1 713 986 5450; fax: +1 713 986 5451. E-mail: Jebudoff{at}yahoo.com.

The "Scratch Test" uses a sharp scalpel to scrape areas of suspected tendinosis in the management of lateral and medial epicondylitis. As claimed in the literature, this tissue is friable and peels off, whereas normal tendon does not. The purpose of this study was to determine whether, or not, the "Scratch Test" is able to differentiate between tendinosis and more normal adjacent tendon. Nineteen specimens from patients treated for tendinosis about the elbow were examined histologically. Three groups of specimens were compared: (1) grossly abnormal tendon, (2) tendon that was scraped out using the "Scratch Test" and (3) tendon that remained behind following the "Scratch Test". There was no significant histological difference between visibly degenerated tendon (group 1) and that which was scraped out using the "Scratch Test" (group 2). There was, however, a significant histological difference between both these groups and the more normal tendon tissue that the "Scratch Test" left behind (group 3).

Key Words: tendinosis • Scratch Test • tendon injury • tennis elbow

Journal of Hand Surgery (European Volume), Vol. 33, No. 2, 166-169 (2008)
DOI: 10.1177/1753193408087108
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