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Physical Exam Wrist
From WikiSM
Introduction
- Follows the IP-PASS examination methodology
- Inspection
- Palpation
- Passive Range of Motion
- Active Range of Motion
- Strength & Neurovascular
- Special Tests
Inspection
- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Swelling
- Muscle tone
- Atrophy, hypertrophy
- Deformity: asymmetry, rotation, amputation
Palpation
- Joint Effusion
- Clicking
- Snapping
- Crepitus
- Tenderness
- Temperature
- Masses
Range of Motion
- Wrist[1]
- Flexion: 80°-90°
- Extension: 60°-70°
- Radial Deviation: 15°-20°
- Ulnar Deviation: 40°-60°
Strength
- Extensors
- Flexors
- Ulnar Deviation
- Radial Deviation
- Supination
- Pronation
Neurovascular
- Sensation
- Recommend: 2 point discrimination (use paper clip)
- Light touch
- Motor Nerves:
- Median Nerve: “A-OK” sign: flexion of the thumb and index finger or thumb and pinky against resistance
- Ulnar Nerve: Test fingers against resistance in abduction
- Radial Nerve: Test thumb extension against resistance
- Anterior Interosseus Nerve: “A-OK” sign
- Posterior Interosseus Nerve: Most hand and wrist extensors
- Vascular
- Radial pulse
- Ulnar pulse
- Allen’s Test
Special Tests
- De Quervains Tenosynovitis
- TFCC Injury
- Wartenbergs Syndrome
- Carpal Tunnel Syndrome
- Scapholunate Instability
- Lunotriquetral Instability
- Distal Radial Ulnar Joint Instability
- Carpometacarpal Arthritis
- Pronator Teres Syndrome
- Extensor Carpi Ulnaris Instability
- Hamate Fracture
See Also
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/
- JAMA: Examination of the Hand and Wrist
References
- ↑ Wilson, COLON H. "The musculoskeletal examination." Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths (1990).
Created by:
John Kiel on 10 September 2019 00:34:16
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Last edited:
26 September 2023 17:16:25
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