Tinel Sign at Elbow |
Examination type |
Neurological |
Patient & Body Segment Positioning |
The patient
should be seated with the involved elbow supported on a flat
surface. The elbow should be flexed to 90 degrees with the arm
externally rotated to expose the cubital tunnel. |
Examiner Position |
The examiner
should stand in front of the patient. One of the examiners
hands should be around the patient’s wrist. The examiner should
use the other hand to tap the patient’s ulnar nerve with a
finger or a reflex hammer. |
Performing the Test |
With firm
pressure, tap between the medial epicondyle and the olecranon
process (in the cubital tunnel) with the tip of a finger or a
reflex hammer. |
Tissues
Being Tested |
Ulnar nerve
|
Positive Test |
If the test
is positive, tingling and numbness will radiate into the 4th
and 5th fingers. Tapping on the involved side should
produce more pain than tapping on the uninvolved side. |
Interpretation |
A positive
test indicates that the ulnar nerve is compromised. |
Common errors in
performing exam |
The
patient’s elbow should be flexed to avoid missing the ulnar
nerve which can produce a false negative test. |
Factors possibly
resulting in misinterpretation |
Everyone
will experience tingling and pain in their 4th and 5th
fingers with continued tapping on the ulnar nerve. Unless the
pain and tingling is severe, the patient or evaluator should not
be concerned. |
Related tests |
Wartenberg’s
Sign, Elbow flexion test, test for pronator teres syndrome,
pinch grip test |
References |
Prentice, W.E. (2003). Arnheim’s Principles of
Athletic Training: A Compentency-Based Approach. New York:
McGraw Hill.
Magee, David
J. (2002). Orthopedic Physical Assessment. Philadelphia,
PA: Elsevier. |
Links: |
http://patients.uptodate.com/image.asp?file=prim_pix/tinelA_si.gif
http://medinfo.ufl.edu/year1/bcs/clist/extrem.html
http://www.merck.com/mrkshared/mmg/sec7/ch55/ch55c.jsp |
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