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Piano Key Test

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Other Names

  • Piano Key Test
  • Piano Sign
  • Piano Test
  • Stress Test
  • Ballottement Maneuver
  • DRUJ Stress Test


Piano Key Test
Demonstration of the Piano Key Test[1]


  • Patient is seated or standing
  • Stabilize radius with one hand, grip ulna with the other
  • Push up and down on the ulna
  • Positive test
    • Pain or laxity



Distal Radial Ulnar Joint Instability

  • Wiffels et al[2], LaStayo et al[3]
    • Sensitivity: 65 - 66%
    • Specificity: 44 - 68%
    • PPV: 24%
    • NPV: 81%

See Also


  1. Qazi, Sohail, et al. "Distal radioulnar joint instability and associated injuries: a literature review." Journal of Hand and Microsurgery 13.03 (2021): 123-131.
  2. Wijffels M, Brink P and Schipper I. Clinical and Non-Clinical Aspects of Distal Radioulnar Joint Instability. The Open Orthopaedics Journal 2012;6:204-210. PMID: 22675411
  3. LaStayo P and Howell J. Clinical provocative tests used in evaluating wrist pain: a descriptive study. J Hand Ther 1995;8(1):10-17. PMID: 7742888
Created by:
John Kiel on 12 July 2019 00:01:12
Last edited:
13 May 2023 18:30:39