Grind Test | CMC 1 Osteoarthritis

Summary

This video demonstrates the grind test for diagnosing carpal metacarpal osteoarthritis (CMC OA). It discusses thumb osteoarthritis, its prevalence, symptoms, and diagnostic methods. The grind test, which involves rotating the thumb metacarpal while applying pressure, has a 64% sensitivity and 100% specificity for CMC OA. The video emphasizes that CMC OA diagnosis relies on clinical assessment and radiographic imaging may not always correlate with symptoms. Viewers are encouraged to check out the Upper Limb Focus course on the wrist and hand for more detailed information.

Takeaways

• 👨‍⚕️ The video demonstrates the grind test for carpal metacarpal osteoarthritis, a condition that affects a large proportion of adults.
• 📈 Radiographic prevalence of thumb osteoarthritis reaches 90 percent in both men and women by age 80, indicating its widespread nature.
• 😖 This condition can cause pain at the base of the thumb, progressive loss of motion, weakness, and decreased coordination, which worsens over time.
• 🔍 Diagnosis involves qualitative assessment of history, physical examination, and radiographs, with the grind test being a key diagnostic tool.
• 📚 A 2017 study by Saliental compared four provocative tests and found the grind test to have a sensitivity of 64 percent and a specificity of 100 percent.
• 🚫 A negative grind test does not necessarily imply the absence of radiographic evidence of osteoarthritis, as clinical diagnosis is still required.
• 👨‍🏫 To conduct the grind test, the patient sits with their hand on a stable surface, and the examiner stabilizes the wrist while applying axial pressure on the trapezium.
• ✅ A positive grind test is indicated by the patient reporting pain or sensations like crepitus in the thumb's basal joint region.
• 📚 The video promotes an Upper Limb Focus course for further learning about wrist and hand diagnosis and treatment.
• 👍 The video encourages viewers to like, subscribe, and visit the physiotutors.com website for more educational content.
• 👋 The video concludes with a thank you from the presenter and an invitation to see viewers in the next video.

Q & A

What is the purpose of the video?

The purpose of the video is to demonstrate the grind test for carpal metacarpal osteoarthritis and to provide information on diagnosing and treating this condition.

What is thumb osteoarthritis and why is it significant?

Thumb osteoarthritis is a painful and debilitating condition that affects a large proportion of the adult population, with radiographic prevalence reaching 90 percent in both men and women by the age of 80. It is significant because it can cause pain, progressive loss of thumb motion, weakness, and decreased coordination.

What are the factors considered in the qualitative assessment for diagnosing thumb CMC arthritis?

The factors considered include the location, duration, onset, frequency, intensity, and quality of the pain.

What study did Saliental conduct in 2017 and what was its purpose?

Saliental conducted a comparative study in 2017 to determine the best diagnostic tests for thumb CMC osteoarthritis by comparing the results of four provocative tests with the Eden-Littler classification system of radiologic evaluation of the CMC joint.

What were the results of Saliental's study regarding the grind test's sensitivity and specificity?

In Saliental's study, the grind test yielded a sensitivity of 64 percent and a specificity of 100 percent.

What does a positive grind test indicate for a patient?

A positive grind test indicates the presence of CMC osteoarthritis, as it confirms the diagnosis and may distinguish those who do not have it.

What is the clinical value of the grind test according to the video?

The grind test has moderate clinical value as it helps in diagnosing CMC osteoarthritis, but a negative test does not necessarily imply the absence of radiographic evidence of the condition.

How is the grind test conducted during an examination?

The test is conducted with the patient in a sitting position, with the hand placed on a stable surface. The examiner stabilizes the patient's hand and wrist with one hand and grasps the thumb metacarpal with the other, rotating it while applying axial pressure on the trapezium.

What is considered a positive result for the grind test?

The grind test is considered positive if the patient reports any pain, even a slight painful sensation, or other sensations such as crepitus in the basal joint region of the thumb.

What additional resources are offered by Physiotutors for learning more about wrist and hand conditions?

Physiotutors offers an Upper Limb Focus course on the wrist and hand, taught by experts Thomas Mitchell and Andrew Cuff, which provides more information on diagnosis and treatment of various conditions in that area.

How can viewers access more content from Physiotutors?

Viewers can access more content by visiting Physiotutors' website at visitutors.com, subscribing to their YouTube channel, or checking the video description for links to online courses.