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J Wrist Surg
DOI: 10.1055/a-2498-0718
Scientific Article

Validation of a New Clinical Test for Diagnosis of Trapeziometacarpal Arthritis

Alvaro Antonio Kafury 
1   Department of Orthopaedic Surgery, Clínica Imbanaco, Grupo Quirónsalud, Pontificia Universidad Javeriana, Cali, Colombia
,
María Elisa Novillo
2   Department of Orthopaedic Surgery, Clínica Imbanaco, Grupo Quirónsalud, Cali, Colombia
,
Fredy Angarita
3   Department of Hand Surgery, Clínica Portoazul, Barranquilla, Colombia
,
Jhon Freddy Castañeda
4   Department of Orthopaedic Surgery, Hospital Universitario Nacional de Colombia, Bogotá, Colombia
,
Juliana Andrea Rojas
1   Department of Orthopaedic Surgery, Clínica Imbanaco, Grupo Quirónsalud, Pontificia Universidad Javeriana, Cali, Colombia
,
Sandra Patricia Muñoz
5   Department of Radiology, Clínica Imbanaco, Grupo Quirónsalud Cali, Cali, Colombia
› Author Affiliations
Funding None.
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Abstract

Purpose Symptomatic trapeziometacarpal arthrosis is primarily diagnosed on clinical grounds. The X-ray appearance correlates poorly with the presence and severity of pain; therefore, radiography is not a useful tool to define which patient is symptomatic, nor which one should be treated. There is not a specific gold standard test. The grind test is the most used clinical test; however, its level of diagnostic accuracy is not very high. The aim of this study is to describe and validate a new clinical test.

Materials and Methods A prospective study was conducted to evaluate the diagnostic performance and reliability of the compression and flexion test.

Results A total of 106 patients were included. Excellent interobserver agreement was found for both semiology tests (kappa = 0.82 and intraclass correlation coefficient = 0.97). The area under the curve for the compression and flexion test showed an estimate of 99.2 (95% confidence interval [CI]: 97.6–100) and for the grind test of 62 (95% CI: 51.2–71.9). The diagnostic performance of the compression and flexion test showed a sensitivity of 100% (95% CI: 92.1–99.9) and a specificity of 98.4% (95% CI: 91.2–100), in contrast to the grind test that reports a sensitivity of 22.2% (95% CI: 11.2–37.1) and a specificity of 93.4% [95% CI: 84.1–98.2].

Conclusions The diagnostic performance of the compression and flexion test is higher than that of the grind test. Furthermore, the results show an excellent interobserver correlation and diagnostic accuracy, making it a useful clinical tool for the diagnosis of trapeziometacarpal arthritis.

Type of Study/Level of Evidence Diagnostic tests II.

Keywords

rhizarthrosis - thumb - arthrosis of the thumb - thumb base arthrosis - grind test - compression and flexion test - trapeziometacarpal joint - physical exam - diagnostic test

Ethical Approval

This study was approved by the Institutional Research Ethics Committee.


Patients' Consent

All patients agreed to enter the study voluntarily by signing an informed consent form.




Publication History

Received: 04 June 2024

Accepted: 06 December 2024

Article published online:
05 February 2025

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