Grind Test | CMC 1 Osteoarthritis
Summary
TLDRThis 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.
Outlines
🤕 Introduction to the Grind Test for Thumb Osteoarthritis
This paragraph introduces a video by physiotutors that demonstrates the grind test for diagnosing carpal metacarpal osteoarthritis. The condition is described as painful and debilitating, affecting a significant portion of the adult population, with a high radiographic prevalence by age 80. The video aims to assess the history, physical examination, and radiographs for diagnosing thumb CMC arthritis, and emphasizes the importance of considering the pain's characteristics. A comparative study by Saliental in 2017 is mentioned, which evaluated the effectiveness of different diagnostic tests, highlighting the grind test's sensitivity and specificity. The paragraph concludes by explaining the clinical value of the grind test and its role in confirming the diagnosis of CMC osteoarthritis, while noting that radiographic evidence does not always correlate with pain or disability.
Mindmap
Keywords
💡Carpal Metacarpal Osteoarthritis
💡Grind Test
💡Sensitivity and Specificity
💡Radiographic Prevalence
💡Qualitative Assessment
💡Eden Littler Classification System
💡Clinical Diagnosis
💡Axial Pressure
💡Crepitus
💡Physical Examination
💡Physiotutors
Highlights
Introduction to the grind test for carpal metacarpal osteoarthritis.
Thumb osteoarthritis affects a large proportion of the adult population.
Radiographic prevalence of thumb osteoarthritis reaches 90 percent in both men and women by the age of 80.
Thumb osteoarthritis can cause pain at the base of the thumb, progressive loss of thumb motion, weakness, and decreased coordination.
Qualitative assessment of history, physical examination, and radiographs are used to diagnose and treat thumb CMC arthritis.
A 2017 study by Saliental compared diagnostic tests for thumb CMC osteoarthritis.
The grind test in the study yielded a sensitivity of 64 percent and a specificity of 100 percent.
The grind test confirms the diagnosis of CMC osteoarthritis and may distinguish those who do not have it.
A negative grind test does not always imply negative radiographic evidence of thumb CMC osteoarthritis.
Thumb CMC osteoarthritis remains a clinical diagnosis, and radiographic changes do not necessarily need to cause disability or pain.
Moderate clinical value is given to the grind test.
Test procedure: Patient is in a sitting position with the hand placed on a stable surface.
The examiner grasps the patient's hand and wrist to stabilize it, keeping the wrist and metacarpals in neutral position.
The examiner grasps the thumb metacarpal, rotates it, and applies axial pressure on the trapezium.
The grind test is considered positive if the patient reports any pain or other sensations such as crepitus in the basal joint region of the thumb.
Conclusion: For more information on wrist and hand diagnoses and treatments, check out the Upper Limb Focus course on the wrist and hand.
Transcripts
in this video I'm going to demonstrate
the grind test for carpal metacarpal
osteoarthritis
[Music]
check out our online courses now the
link is in the video description
hi and welcome back to physiotutors
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. this condition can cause pain at
the base of the thumb Progressive loss
of thumb motion weakness and decreased
coordination which worsens over time
qualitative assessment of the history
physical examination and radiographs is
used to diagnose and treat thumb CMC
arthritis the location duration onset
frequency intensity and quality of the
pain are all under consideration in 2017
saliental conducted a comparative study
to determine the best diagnostic tests
for cmcoa of the thumb by comparing the
results of four provocative tests with
the Eden littler classification system
of radiologic evaluation of the CMC
joint
in their study the grind test yielded a
sensitivity of 64 percent and a
specificity of 100 percent the grind
test both confirms the diagnosis of CMC
osteoarthritis and may distinguish those
who do not have it a negative grind test
however does not always imply negative
radiographic evidence of thumb CMC
osteoarthritis with OA it has to be
added that it remains a clinical
diagnosis and changes seen on
radiographic Imaging don't necessarily
need to cause any disability or pain
which is why we give this test a
moderate clinical value to conduct the
test the patient is in sitting position
and the hand is placed on a stable
surface such as the examination table
The Examiner grasps the patient's hand
and wrist with one hand in order to
stabilize it
the patient's wrist and metacarpals are
in neutral position with the other hand
the examiner grasps the thumb metacarpal
and rotates it all while applying axial
pressure on the trapezium
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 alright that's
it for this video if you want to learn
more about the wrist and hand the
diagnosis that can be found in that area
and how to treat these various
conditions check out our Upper Limb
Focus course on the wrist and hand with
experts Thomas Mitchell and Andrew cuff
the link is in the video description
down below the like button if you
enjoyed this video give it a thumbs up
and subscribe to our Channel if you
haven't yet for more content head to our
website visitutors.com and as always
this was something else for physio
tutors thank you very much for watching
I will see you next time bye
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