OnExam
Inspection
- Inspect the dorsal and volar surfaces of wrist
- Radial styloid
- Ulnar styloid
- Thenar (median nerve) and hypothenar (ulnar nerve) eminences for muscle wastingul>
- Radius/Ulna for deformity (eg.Colles or Smith's Fractures)
Palpation
- Note areas of pain, swelling, spasm, atrophy, ligamentous laxity, deformity or crepitus in the following structures:
- Radial styloid process
- Ulnar styloid process
- Carpal bones
- Radioulnar articulation
- Scaphoid within anatomic snuffbox
- Abductor pollicis longus
- Extensor pollicis brevis
- Extensor pollicis longus
- Thenar and hypothenar eminences
- Radial and ulnar pulses
Range of Motion
- Flexion (normal = 90°), “Palm towards forearm”
- Extension (normal = up to 70°), “Back of hand towards forearm”
- Ulnar deviation (normal = up to 50°), “5th finger towards forearm”
Radial deviation (normal = up to 20°), “Thumb towards forearm""
Carpal Tunnel Syndrome Tests
References
- Baxter S, ed., McScheffrey G, ed. Toronto Notes: Comprehensive Medical Reference & Review for MCCQE 1 & USMLE 2. 26th ed. Toronto: Toronto Notes for Medical Students Inc; 2010.
- Bickley L. Bate’s Guide to Physical Examination and History Taking. 10th ed. New York: Lippincott Williams & Wilkins; 2009.
- Hurley K. OSCE and Clinical Skills Handbook. Halifax: Elsevier Canada; 2005.