In the study of 272 consecutive patients with wrist pain who had undergone arthroscopy, a Mayo Clinic team discovered that a positive "ulnar fovea sign" was highly effective in diagnosing either a complete ligament rupture or the newly described condition: a split tear of the ulnotriquetral (UT) ligament. The test involves pressing the ulnar fovea region of the patients' wrists to determine tenderness. The researchers found a positive ulnar fovea test was 95 percent sensitive in revealing patients with a rupture or a UT split tear. The test's specificity was 86.5 percent.
Richard Berger, M.D., Ph.D., who led the study, says the UT split tear is a common but heretofore undefined injury, in which the wrist joint is stable but painful. "The UT split tear is different, because the ligament is still attached to the bones on both ends, but is split open lengthwise," Berger continues. "The joint is stable, and the patient can have a Magnetic Resonance Imaging (MRI) that would be interpreted as normal because there isn't a complete severing of the ligament. Even looking inside the joint with an arthroscope, the split tear isn't immediately obvious unless you know what to look for."
As Berger performed the ulnar fovea test on subsequent patients and followed with arthroscopic examination, he noticed that a large majority of those with the positive ulnar fovea sign but stable joints had UT split tears. "It's good news that this simple test is so effective at pinpointing the problem," he says. "What's even better is that we have a treatment that can restore full, pain-free function and improve quality of life for decades for these mostly younger patients." Berger uses arthroscopically guided surgery to suture the ligament and repair the split. After six weeks in a cast that immobilizes the wrist, the patient begins rehabilitation.
MEDICA.de; Source: Mayo Clinic