Execution
- 1Position the patient’s arm in approximately 20° of elbow flexion with the forearm supinated.
- 2Identify the region just proximal to the cubital tunnel.
- 3Apply external pressure over the ulnar nerve region.
- 4Maintain the pressure for 60 seconds.
- 5Ask whether numbness or paresthesia worsens in the ulnar nerve distribution.
Positive outcome
Worsening numbness or paresthesia in the ulnar distribution is positive. Magee describes the test as direct pressure near the cubital tunnel for 60 seconds.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Novak et al. (1994) | NA | 89 | 98 | 44.5 | 0.11 |
CommentThe pressure provocation test has strong rule-in values in Magee’s eAppendix, but those estimates come from one key provocative-testing study. It is simple and directly targets the cubital tunnel, but may be less informative in patients with diffuse neuropathy or double-crush features. Pair it with Tinel, flexion / compression, sensory distribution, and intrinsic motor testing.
High Clinical Value