x
x

Shuck Test

Exams and Signs

Description

  • The shuck test can aid in the diagnosis of a lunotriquetral (LT) ligament injury or tear. It is important to consider lunotriquetral injury in the evaluation of ulnar-sided wrist pain.1 

Pathophysiology

  • An LT ligament injury may arise from a fall on an outstretched hand (FOOSH). With LT injuries, there are often associated carpal bone, carpal ligament and triangular fibrocartilage complex (TFCC) injuries.1

Instructions

  1. Place the patient’s elbow flat on the table with the forearm in neutral and the wrist elevated perpendicular to the table2
  2. Place one hand on the patient, holding the lunate volarly and dorsally, while placing the other hand on the patient’s triquetrum
  3. Attempt to shift them by pushing with one hand and pulling with the other2
  4. Check for pain and crepitus
  5. Repeat this movement and observation on the opposite hand for comparison

Variations

  • Before conducting the shuck test, perform a pisotriquetral (PT) grind test. If this is negative, it will rule out concomitant PT joint pathology.3

Related Signs and Tests

  • PT grind test
  • Kleinmann shear test
  • Ulnar snuff box test 3
  • Arthrography
  • Magnetic resonance imaging (MRI)

Diagnostic Performance Characteristics

  • For improved reliability, the shuck test should be used in conjunction with other physical tests that apply a load on the support ligaments in the wrist.4
Definition of Positive Result
  • A positive result occurs when the patient experiences pain, crepitus and/or excessive laxity.3
Definition of Negative Result
  • A negative result occurs when the patient does not experience pain, crepitus or excessive laxity.
Comments and Pearls
  • If the PT joint is diseased or injured, as in osteoarthritis, the shuck test can lead to false-positive findings.4
Diagnoses Associated with Exams and Signs
References
  1. Butterfield WL, Joshi AB, Lichtman D. Lunotriquetral Injuries. J Hand Surg Am 2002;2(4):195-203.
  2. Culp R, Jacoby S. Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple. New Jersey: SLACK Incorporated, 2012
  3. Rhee PC, Sauvé PS, Lindau T, Shin AY. Examination of the Wrist: Ulnar-sided Wrist Pain Due to Ligamentous Injury. J Hand Surg Am 2014;39:1859-62. PMID: 25091336
  4. Kleinman WB. Physical Examination of the Wrist: Useful Provocative Maneuvers. J Hand Surg Am 2015;40(7):1486-1500. PMID: 26043802
Subscribe to Shuck Test
⇡