The Ulnocarpal Stress Test in the Diagnosis of Ulnar-Sided Wrist Pain

Abstract

Forty-five patients with persistent ulnar-sided wrist pain and a positive ulnocarpal stress test were investigated by X-ray, arthrography, 99mTechnetium bone scanning, magnetic resonance imaging and wrist arthroscopy. Ulnar wrist pathology was positively identified in nine of 45 patients by X-ray, 18 of 37 by arthrography, 19 of 27 by bone scan, four of 33 by MRI, and in all 45 patients by arthroscopy. The final diagnosis was ulnocarpal abutment syndrome in 28 patients, traumatic triangular fibrocartilage (TFC) tear in six, lunotriquetral (LT) ligament tear in five, TFC and LT ligament tear in one, wrist arthritis in four and cartilaginous free body in one. The ulnocarpal stress test is a useful provocative test, and a positive test suggests the presence of ulnar-sided wrist pathology. The test is sufficiently sensitive to warrant further investigation by arthroscopy.

Ulnar-sided Wrist Pain: Evaluation and Treatment of Triangular Fibrocartilage Complex Tears, Ulnocarpal Impaction Syndrome, and Lunotriquetral Ligament Tears

“…The subsequent rotation causes nonuniform strain to the ulnar structures, with the combination of the 2 reproducing pain. Nakamura et al 11 found that patients with a positive ulnocarpal stress test had TFCC injuries, LT ligament injuries, ulnocarpal abutment syndrome, arthritis, and a joint mouse. Therefore, it is considered a sensitive but nonspecific test for ulnar-sided pathology.…”

Measurement of the Shift in the Distal Radioulnar Joint Using a Custom Platform

“…Due to convenience of physical exams, several methods have been introduced to evaluate subluxation and injury of the DRUJ, including the DRUJ stress test [12], piano-key sign [13], ulnar fovea sign [14], and ulnocarpal stress test [15]. However, these methods rely on objective measures.…”

Klinische Testverfahren zur Überprüfung der Stabilität im distalen Radioulnargelenk

“…Werden so Schmerzen provoziert, ist dies recht unspezifisch und kann aufgrund von Instabilitäten, Lä-sionen des TFCC ("triangular fibrocartilaginous complex"), einem Ulnar-Impaction-Syndrom, lunotriquetraler Bandverletzungen, freien Gelenkkörpern, Arthritiden, Griffelfortsatzfrakturen sowie einer Extensor-carpi-ulnaris-Sehnendislokation entstehen [17].…”