Piano Key Sign: Difference between revisions
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== Purpose == | == Purpose == | ||
[[File:Hand and wrist bones II.JPG|thumb]] | [[File:Hand and wrist bones II.JPG|thumb]] | ||
The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.<ref name=":0">Vezeridis PS, Yoshioka H, Han R, Blazar P. Ulnar-sided wrist pain. Part I: anatomy and physical examination. Skeletal radiology. 2010 Aug;39(8):733-45.</ref> It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the [[Wrist and Hand|wrist]].<ref name=":0" /> | The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.<ref name=":0">Vezeridis PS, Yoshioka H, Han R, Blazar P. [https://scholar.google.com/scholar_url?url=https://link.springer.com/article/10.1007/s00256-009-0775-x&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=7761175368640555877&ei=2mkGYuXxIbeN6rQP8ZCWsAI&scisig=AAGBfm2MFHJEbLLvNs2Dw7wVvxgKk8YYGQ Ulnar-sided wrist pain. Part I: anatomy and physical examination.] Skeletal radiology. 2010 Aug;39(8):733-45.</ref> It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the [[Wrist and Hand|wrist]].<ref name=":0" /> | ||
== Technique == | == Technique == | ||
In the Piano-key Sign Test, the wrist is supported in pronation | In the Piano-key Sign Test, the wrist is supported in pronation and the hand is stabilized in the neutral position. Force is applied to the head of ulna. | ||
=== Positive Result === | === Positive Result === | ||
The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.<ref name=":1">American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990.</ref> This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign.<ref name=":1" /> This instability and pain are judged relative to the contralateral wrist. <ref>Duke Orthopaedics: Wheeless’ | The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.<ref name=":1">American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990.</ref> This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign.<ref name=":1" /> This instability and pain are judged relative to the contralateral wrist. <ref>Duke Orthopaedics: Wheeless’ [https://www.wheelessonline.com/muscles-tendons/tfcc-examination/ Textbook of Orthopaedics][last accessed February 11, 2022].</ref> | ||
=== Negative Result === | === Negative Result === | ||
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== Sensitivity/Specificity == | == Sensitivity/Specificity == | ||
The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59. <ref>Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. The Journal of hand surgery. 2000 May 1;25(3):464-8.</ref> | The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59. <ref>Lindau T, Adlercreutz C, Aspenberg P. [https://scholar.google.com/scholar_url?url=https://www.sciencedirect.com/science/article/pii/S0363502300762782&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=5741249806377052627&ei=6GoGYtGoNYr4yASkqb_4Ag&scisig=AAGBfm3n0zsSEkaiStl7TF4wbn3gLjO5Zg Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures.] The Journal of hand surgery. 2000 May 1;25(3):464-8.</ref> | ||
== References == | == References == |
Revision as of 15:50, 11 February 2022
Original Editor - Joseph Ayotunde Aderonmu
Top Contributors - Joseph Ayotunde Aderonmu, Wendy Snyders and Chelsea Mclene
Purpose[edit | edit source]
The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability.[1] It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the wrist.[1]
Technique[edit | edit source]
In the Piano-key Sign Test, the wrist is supported in pronation and the hand is stabilized in the neutral position. Force is applied to the head of ulna.
Positive Result[edit | edit source]
The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head.[2] This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name "piano-key" sign.[2] This instability and pain are judged relative to the contralateral wrist. [3]
Negative Result[edit | edit source]
No instability or movement observed on removal of pressure on the ulnar head.
Instructional Video[edit | edit source]
Sensitivity/Specificity[edit | edit source]
The Piano-key Sign Test has a specificity of 0.96 and a sensitivity of 0.59. [4]
References[edit | edit source]
- ↑ 1.0 1.1 Vezeridis PS, Yoshioka H, Han R, Blazar P. Ulnar-sided wrist pain. Part I: anatomy and physical examination. Skeletal radiology. 2010 Aug;39(8):733-45.
- ↑ 2.0 2.1 American Society for Surgery of the Hand. The hand: examination and diagnosis. Churchill Livingstone; 1990.
- ↑ Duke Orthopaedics: Wheeless’ Textbook of Orthopaedics[last accessed February 11, 2022].
- ↑ Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. The Journal of hand surgery. 2000 May 1;25(3):464-8.