Execution
- 1Position the patient sitting with the elbow flexed, forearm in neutral rotation, and forearm resting on the table.
- 2Grasp the pisotriquetral complex between the thumb and index finger of one hand.
- 3Grasp the lunate with the thumb and index finger of the other hand.
- 4Move the lunate anteriorly and posteriorly relative to the triquetrum.
- 5Compare laxity, pain, and crepitus with the uninjured wrist.
Positive outcome
Pain, crepitus, or excessive laxity compared with the opposite wrist is positive for lunotriquetral instability. Magee notes that the lunotriquetral shear version loads the pisotriquetral joint while moving the wrist from ulnar to radial deviation. The test is similar to joint play between the lunate and triquetrum.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Reagan et al. — year unverified | NA | NA | NA | NA | NA |
| LaStayo & Howell (1995) — descriptive study | NA | NA | NA | NA | NA |
CommentThis is a provocative instability test with limited diagnostic-accuracy evidence. It requires precise carpal palpation and comparison with the other side. Positive pain without clear laxity may reflect adjacent ulnar-sided pathology rather than isolated lunotriquetral ligament failure.
Low Clinical Value