Execution
- 1Position the patient sitting with the hand on a stable surface.
- 2Stabilize the hand with the wrist and metacarpals in neutral.
- 3Place pressure over the anterior oblique ligament region at the thumb CMC joint.
- 4Create a shearing force by rocking the first metacarpal across the trapezium.
- 5Record any basal thumb pain reproduced by the manoeuvre.
Positive outcome
Any pain in the basal region of the thumb during the pressure-shear manoeuvre is positive. Crepitus may occur but pain reproduction is the main criterion. The test is intended to provoke symptomatic thumb CMC osteoarthritis.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Sela et al. (2019) | NA | 99 | 95 | 19.8 | 0.01 |
CommentSela reported very high sensitivity and specificity, but the pressure-shear test was performed last in a sequence of four provocative tests, which may have sensitized the joint. This makes the point estimate promising but not yet definitive. It may be clinically more useful than grind when screening for painful CMC OA.
High Clinical Value