Execution
- 1Position the patient sitting with the elbow flexed and the hand supported.
- 2Stabilize the hand and wrist to prevent substitution.
- 3Position the thumb metacarpal for provocative adduction at the trapeziometacarpal joint.
- 4Move the thumb firmly into adduction until end range or symptom reproduction.
- 5Record pain at the thumb CMC joint.
Positive outcome
Reproduction of the patient’s thumb CMC joint pain during adduction is positive. Pain away from the basal joint should be interpreted cautiously. The test is intended to detect symptomatic trapeziometacarpal arthritis.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Gelberman et al. (2015) | κ = 0.84 reported for provocation tests | 94 | 93 | 13.43 | 0.06 |
CommentThe adduction test is not described in the retrieved Magee text, so the procedural description is based on the primary trapeziometacarpal arthritis paper and clinical test summaries. Gelberman reported strong values, but further validation outside hand-surgery settings is limited. Use it as a thumb-base OA provocation, not a generalized wrist test.
High Clinical Value