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Athletic Training & Sports Medicine Center

Examination Links:

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Alphabetical Listing
of Examinations
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Head

Cervical Spine

Thoracic Spine

Lumbar Spine

Shoulder

Elbow & Radioulnar

Wrist

Hand & Fingers

Sacroiliac Joint

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Ipsilateral Prone Kinetic Test
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FABER Test
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Passive Extension & Internal 
Rotation of Ilium on Sacrum

Passive Flexion & External 
Rotation of Ilium on Sacrum

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Passive External Rotation 
of Hip
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Pelvic Rocking Test
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Gapping Test
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Prone Gapping (Hibb's) Test
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Approximation Test
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Squish Test
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Sacroiliac Rocking Test
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Sacral Apex Pressure Test
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Torsion Stress Test
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Femoral Shear Test
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Superoinferior Symphysis
Pubic Stress Test

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Piedallu's Sign
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Flamingo Maneuver or Test
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Gaenslen's Sign
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Mazion's Pelvic Maneuver
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Yeoman's Test
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Sit-up Test
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Hip & Thigh

Knee

Lower Leg

Ankle

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Foot
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Morton Test
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Range of Motion
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Goniometry
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Manual Muscle Testing
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Reflexes
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Vital Signs
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Body Composition
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Anatomical Snuffbox Compression Test

Examination type

Bone Integrity

Patient & Body Segment Positioning

Patient should sit in a chair or stool and place forearm on a stable surface such as a counter or examination table. Patient should then actively abduct the thumb.

Examiner Position

Examiner should stand or sit in front of patient’s hand. Examiner places one hand on the patient’s wrist to stabilize the hand while using the other hand to palpate the patient’s anatomic snuffbox.

Performing the Test

The anatomical snuffbox is formed by three tendons and the scaphoid (navicular) bone. The radial border of the snuffbox is formed by the abductor pollicis longus and the extensor pollicis brevis tendons while the ulnar border is formed by the extensor pollicis longus tendon and the floor of the scaphoid (navicular) bone. To perform this test, the examiner should apply compression in the anatomical snuffbox which will also compress the scaphoid (navicular) bone.

Tissues Being Tested

Scaphoid (Navicular) Bone

Positive Test

Severe point tenderness on palpation of the anatomic snuffbox

Interpretation

Possible Scaphoid Fracture

Common errors in performing exam

There are other structures present in the snuff box such as the radial nerve, radial artery, the scapho-trapezial joint, and the radial collateral ligament. Palpation of one of these structures instead of the scaphoid can cause an error in the exam.

Factors possibly resulting in misinterpretation

Compression of the radial nerve can cause pain on palpation of the anatomical snuffbox. Clicking is an indication of a scapho-lunate ligamentous injury but can be mistaken for crepitus with a scaphoid fracture. The snuffbox can also be tender on palpation if the radial collateral ligament has been injured.

Related tests

Watson’s shift test (move wrist from ulnar to radial deviation while palpating scaphoid), the scaphoid compression test (longitudinally compressing the thumb along the line of the first metacarpal), passive wrist hyperextension, and passive pronation of the wrist with ulnar deviation.

References

Booher, James M., & Thibodeau Gary A. (2000). Athletic Injury Assessment Fourth Edition. U.S.A.: McGraw-Hill.

Cartwright, Lorin A. & Pitney, William A. (1999). Athletic Training for Student Assistants. U.S.A.: United Graphics.

Hoppenfeld, Stanley. (1976). Physical Examination of the Spine and Extremities. New Jersey: Prentice Hall.

Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA: Elsevier.

Prentice, William E. (2003). Arnheim’s Principles of Athletic Training A Competency-Based Approach. U.S.A.: McGraw-Hill Companies, INC.

Links:

http://www.cathnet.net/articles/Textbook/111_wristinjuries.htm

http://instruct.uwo.ca/kinesiology/222/Lab5/lab5.html

http://www.interlog.com/~thig/minutes%20jan2002.html

http://www.aafp.org/afp/20040901/879.html

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