Piano Key Sign: Difference between revisions
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== Purpose == |
== Purpose == |
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[[File:Hand and wrist bones II.JPG|thumb]] |
[[File:Hand and wrist bones II.JPG|thumb]] |
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The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.Vezeridis PS, Yoshioka H, Han R, Blazar P. Ulnar-sided wrist pain. Part I: anatomy and physical examination. Skeletal radiology. 2010 Aug;39(8):733-45. It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the [[Wrist and Hand|wrist]]. |
The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.Vezeridis PS, Yoshioka H, Han R, Blazar P.[https://scholar.google.com/scholar_url?url=https://link.springer.com/article/10.1007/s00256-009-0775-x&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=7761175368640555877&ei=2mkGYuXxIbeN6rQP8ZCWsAI&scisig=AAGBfm2MFHJEbLLvNs2Dw7wVvxgKk8YYGQUlnar-sided wrist pain. Part I: anatomy and physical examination.]Skeletal radiology. 2010 Aug;39(8):733-45. It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the [[Wrist and Hand|wrist]]. |
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== Technique == |
== Technique == |
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In the Piano-key Sign Test, the wrist is supported in pronation |
In the Piano-key Sign Test, the wrist is supported in pronationandthe hand is stabilized in the neutral position. Forceis applied to the head ofulna. |
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=== Positive Result === |
=== Positive Result === |
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The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990. This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign. This instability and pain are judged relative to the contralateral wrist. Duke Orthopaedics: Wheeless’ |
The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990. This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign. This instability and pain are judged relative to the contralateral wrist. Duke Orthopaedics: Wheeless’[https://www.wheelessonline.com/muscles-tendons/tfcc-examination/Textbook of Orthopaedics][last accessedFebruary11,2022]. |
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=== Negative Result === |
=== Negative Result === |
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== Sensitivity/Specificity == |
== Sensitivity/Specificity == |
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The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. The Journal of hand surgery. 2000 May 1;25(3):464-8. |
The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59. Lindau T, Adlercreutz C, Aspenberg P.[https://scholar.google.com/scholar_url?url=https://www.sciencedirect.com/science/article/pii/S0363502300762782&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=5741249806377052627&ei=6GoGYtGoNYr4yASkqb_4Ag&scisig=AAGBfm3n0zsSEkaiStl7TF4wbn3gLjO5ZgPeripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures.]The Journal of hand surgery. 2000 May 1;25(3):464-8. |
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== References == |
== References == |
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Latest revision as of 15:50, 11 February 2022
Original Editor-Joseph Ayotunde Aderonmu
Top Contributors-Joseph Ayotunde AderonmuandChelsea Mclene
Purpose[edit|edit source]
The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.[1]It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of thewrist.[1]
Technique[edit|edit source]
In the Piano-key Sign Test, the wrist is supported in pronation and the hand is stabilized in the neutral position. Force is applied to the head of ulna.
Positive Result[edit|edit source]
The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.[2]This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign.[2]This instability and pain are judged relative to the contralateral wrist.[3]
Negative Result[edit|edit source]
No instability or movement observed on removal of pressure on the ulnar head.
Instructional Video[edit|edit source]
Sensitivity/Specificity[edit|edit source]
The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59.[4]
References[edit|edit source]
- ↑1.01.1Vezeridis PS, Yoshioka H, Han R, Blazar P.Ulnar-sided wrist pain. Part I: anatomy and physical examination.Skeletal radiology. 2010 Aug;39(8):733-45.
- ↑2.02.1American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990.
- ↑Duke Orthopaedics: Wheeless’Textbook of Orthopaedics[last accessed February 11, 2022].
- ↑Lindau T, Adlercreutz C, Aspenberg P.Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures.The Journal of hand surgery. 2000 May 1;25(3):464-8.
