Cozen’s Test
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Purpose[edit | edit source]
The purpose of Cozen's test (also known as the "resisted wrist extension test" or "resistive tennis elbow test") is to check for lateral epicondylalgia or "tennis elbow".
Patient Position[edit | edit source]
The patient should be seated, with the elbow extended forearm maximal pronation, wrist radially abducted, and hand in a fist.
Examiner Position[edit | edit source]
The therapist should stabilise elbow while palpating lateral epicondyle, other hand placed on the dorsum of the hand.
Technique[edit | edit source]
The patient is asked to move the wrist to dorsal flexion and the therapist provides resistance to this movement, in the position described above.[1] The test is positive if pain on the lateral epicondyle is elicited.
Cozen's test video provided by Clinically Relevant
Helpful Tips[edit | edit source]
To reduce the likelihood of finding pathology at the origin of extensor digitorum, keep the patient’s fingers flexed during resisted wrist extension. During isometric wrist extension, the counter-force should be applied on the dorsoradial aspect of the fist to reduce involving extensor carpi ulnaris and thus obtaining a false-positive finding if there is pathology within this muscle/tendon.[2]
Evidence[edit | edit source]
A recent study by Karanasios et al stated that physical examination tests’ diagnostic accuracy has been under-researched but available evidence suggests that the Cozen’s test reported high sensitivity (91%) while a grip strength difference of 5%-10% between elbow flexion and extension showed high sensitivity (78%-83%) and specificity (80%-90%)[3]. Despite the limited evidence, Karanasios et al concluded that the Cozen's test can be used to rule out lateral epicondylitis during a physical examination, and that the grip strength difference between elbow flexion and extension has good diagnostic values for determining the presence and absence of lateral epicondylitis, especially when used in conjunction with diagnostic tests such as ultrasound and MRI.[3].
References[edit | edit source]
- ↑ Zwerus EL, Somford MP, Maissan F, Heisen J, Eygendaal D, van den Bekerom MP. Physical examination of the elbow, what is the evidence? A systematic literature review. Br J Sports Med. 2018 Oct 1;52(19):1253-60.
- ↑ Kochar M, Dogra A. Effectiveness of a specific physiotherapy regimen on patients with tennis elbow: clinical study. Physiotherapy, 2002; 88: 333–341.
- ↑ 3.0 3.1 Karanasios S, Korakakis V, Moutzouri M, Drakonaki E, Koci K, Pantazopoulou V, Tsepis E, Gioftsos G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)-a systematic review. Journal of Hand Therapy. 2021 Feb 27.
