Clinical tests for assessing the presence and quality of the palmaris longus tendon: diagnostic accuracy of examination compared with ultrasound

Abstract

Various clinical tests are used to evaluate the palmaris longus tendon, but their accuracy is unknown. We assessed the accuracy of clinical tests (Schaeffer’s, Thompson’s, Mishra-I, Mishra-II) against ultrasound as the reference standard. We hypothesized that Schaeffer’s was most accurate and that examination can reliably assess the palmaris longus tendon’s length. Ninety-six wrists were examined clinically and evaluated with ultrasound by radiologists who were blinded to examination results. We calculated diagnostic accuracy and agreement between length measurements. Sensitivity values were as follows: Schaeffer’s 94%, Mishra-I 100%, Mishra-II 100%, Thompson’s 72%. Specificity values were as follows: Schaeffer’s 94%, Mishra-I 83%, Mishra-II 89%, Thompson’s 91%. Intraclass correlation coefficient between palmaris longus tendon length measurement on examination and ultrasound was 0.54. Schaeffer’s test accurately detected this tendon with >90% sensitivity and specificity, but clinical examination less reliably measured palmaris longus tendon length. Ultrasound may be a useful adjunct to assess potential graft length preoperatively. Level of evidence: I

Assessing the Accuracy of Common Clinical Tests for Detecting Palmaris Longus: A Prospective Study in a Tertiary Center

“…In this study, Thompson's test showed the presence of 109 (79.6%) tendons in the right hand and 106 (77.4%) tendons in the left hand. Our study varies with the studies conducted by Kigera and Mukwaya 1 and Johnson et al 8 where Thompson's test detected tendons in 90.7 and 91%, respectively, of all the participants.…”

Prevalência de ausência de tendão palmaris longus em uma amostra populacional de uma cidade brasileira multiétnica*

“…O teste de Schaeffer detectou com precisão este tendão com > 90% de sensibilidade e especificidade. 30…”

“…The Schaeffer test accurately detected this tendon with > 90% sensitivity and specificity. 30 The studies to determinate the prevalence of absence of PLT present different amount of subjects avaluated. Alves et al, 17 In our study we obtained a PLT absence rate of 26.2%.…”

“…O coeficiente de correlação intraclasse entre a medição do comprimento do tendão palmaris longus no exame e o ultrassom foi de 0,54. O teste de Schaeffer detectou com precisão este tendão com > 90% de sensibilidade e especificidade 30. Os estudos para determinar a prevalência de ausência de tendão palmaris longus apresentam diferentes quantidade de indivíduos avaliados.…”

Türk Populasyonunda Musculus Palmari̇s Longus Ve Musculus Flexor Digitorum Superficialis’i̇n Gösteri̇mi̇nde Kullanilan Testler Arasindaki̇ Uyumun İncelenmesi̇

“…PL varlığının belirlenmesinde referans alınan çok az standart test bulunmaktadır. Bu testlerle birlikte operasyon öncesi bulgular veya gelişmiş görüntüleme yöntemleri PL tendonunun varlığını veya yokluğunu göstermektedir (13). Literatürde PL varlığının de-ğerlendirilmesinde standart olan Schaeffer testi (12), Thompson testi (14), Mishra I testi ve Mishra II testi (15) ve Pushpakumar iki parmak belirtisini (16) testleri kullanılmaktadır.…”