Clinical tests in the diagnosis of scapholunate ligament injuries

Abstract

BACKGROUND:Non-invasive instrumental methods of scapholunate ligament injuries, one of the main wrist joint stabilisers, are complicated by frequent false results of examination, and therefore clinical testing is essential in making the diagnosis. At the same time, the limited number of existing specific tests requires evaluation of their prognostic accuracy. AIM:Evaluating the diagnostic significance of alternative specific tests in the diagnosis of scapholunate ligament injuries. MATERIALS AND METHODS:In this study, we performed clinical examination and testing of both carpal joints in 50 subjects who had no complaints of carpal joint dysfunction or pain and denied a history of trauma. In clinical testing, the presence or absence of pain during palpation in the projection of the scapholunate ligament was analysed, as well as the specific Watson test, the navicular balloting test and the Kleinman test, for which specificity was assessed. RESULTS:The specificity of scapholunate ligament palpation as a diagnostic test was 84.0%, Watson test — 96.0%, navicular balloting test — 98.0%, Kleinman test — 87.0%. The overall specificity of clinical tests was 79.0%. A combination of Watson test, navicular balloting test and Kleinman test achieved the highest specificity (86.0%). CONCLUSIONS:Clinical testing is an important diagnostic tool in suspected scapholunate ligament injuries, however the benefit of isolated clinical tests is not absolute and therefore the best algorithm for clinical examination of the wrist joint may be the use of several specific clinical tests in combination.