Take watch off
Look
Palm up
- thenar wasting
- STT gangion
- thumb OA
- flexor synovitis
Thumb up
- thenar wasting
Palm down
- dorsal SL ganglion
- extensor synovitis
Palms together
- claw ulna
- elbow scars
Move
Wrist
- extension
- flexion
- radial / ulna deviation
- pronation / supination (thumb up)
Finger flex and extend
- thumb in and out
- spread fingers
Feel
Sensation
- ulna nerve / radial / median nerve / CTS
Radial side
Distal Radius
1st extensor compartment
- swelling EPB / APL
- Finklestein's
- flex and extend thumb
- feel crepitus
Intersection
- tenderness crossover EPB APL
Scaphoid
- snuffbox
- tuberosity
- Watson's test
Base of thumb
- tenderness
- deformity
- Grind Test
MCPJ thumb
- tenderness
- weakness ulna collateral
SL joint
Wartenberg's radial neuritis
Ulna side
ECU tendon
Lunotriquetral joint
- instability test
- one under each thumb & toggle
- look for movement or pain
Ulna head
- deformity
- instability
Hamate Hook
- tenderness with #
DRUJ
- synovitis
- tenderness
- piano key
- pro/sup subluxation, pain, clicking
TFCC
- palpate for tenderness distal to ulna
- Grind test circ & press
- look for pain & crepitus
PisoTriquetral Joint
- occupational injury
- press & rock against Triquetrum
- look for pain & crepitus
- similar concept to patella
Guyon's canal
- Tinel's
Other
Allen's test
CTS
Ulna Nerve