Scratch Collapse Test

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed and Lucinda hampton

Purpose[edit | edit source]

Scratch Collapse Test is a diagnostic test for carpal tunnel syndrome and cubital tunnel syndrome.

Technique[edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Ask the patient to flex the bilateral elbow 90 degree, then examiner applies internal rotation force over the distal arm while asking patient to resist.

Step 3. While in above position examiner applies scratch over the nerve compression area on affected elbow, then immediately repeat above step 2 (examiner applies internal rotation force over the distal arm while asking patient to resist.)

Step 4. Positive test indicates temporary loss of resistance to force applied by the examiner on the affected side.

Evidence[edit | edit source]

carpal tunnel syndrome cubital tunnel syndrome
sensitivity 64%[3]31%[4]32%[5] sensitivity 69%[3]
Specificity 99%[3] 61%[4] Specificity 99%[3]
Positive Predictive Value 99%[3] Positive Predictive Value 99%[3]
Negative Predictive Value 73%[3][3] Negative Predictive Value 86%[3]
Accuracy 82%[3] Accuracy 89%[3][3]

References[edit | edit source]

  1. Utility of Scratch Collapse Test in a Case of Failed Carpal Tunnel Releases. WUSTL Learn Surgery. Available from: https://youtu.be%7CxadO8ie7mXg
  2. Scratch Collapse Test for testing nerve injury - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://youtube%7CmPeFjQLjMQM
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. J Hand Surg Am. 2008 Nov;33(9):1518-24. doi: 10.1016/j.jhsa.2008.05.022. PMID: 18984333.
  4. 4.0 4.1       1. Makanji HS, Becker SJE, Mudgal CS, Jupiter JB, Ring D. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome. Journal of Hand Surgery (European Volume). 2014;39(2):181-186. doi:10.1177/1753193413497191  
  5. Blok RD, Becker SJ, Ring DC. Diagnosis of carpal tunnel syndrome: interobserver reliability of the blinded scratch-collapse test. J Hand Microsurg. 2014;6(1):5-7. doi:10.1007/s12593-013-0105-3