What provocative testing of the lunotriquetral joint is performed in the evaluation of ulnar-sided wrist pain?

Updated: Nov 22, 2019
  • Author: David M Lichtman, MD; Chief Editor: Harris Gellman, MD  more...
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Answer

Reagan et al described the lunotriquetral ballottement test, which can be used to elicit the laxity that is associated with pain and crepitus in the presence of instability. [9] To perform this test, the lunate is stabilized with the thumb and index fingers of one hand, while the other hand attempts to displace the pisotriquetral unit volarly, then dorsally.

In the shuck test, the lunate is stabilized with the same technique that is used in the ballottement test. The wrist is then taken through both active and passive radial and ulnar deviation. The test results are positive if pain or clicking at the lunotriquetral joint is present.

The ulnar snuffbox test is performed by applying radial pressure in the sulcus between the extensor carpi radialis and the flexor carpi ulnaris (FCU) distal to the ulnar head. The results are considered positive if the patient's pain is reproduced, suggesting triquetral chondromalacia or lunotriquetral injury. In addition, the examiner may wish to inject approximately 0.5 mL of lidocaine into the lunotriquetral joint to differentiate intra-articular from extra-articular pathology.


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