• J Hand Ther · Jul 2010

    Diagnostic value of clinical grind test for carpometacarpal osteoarthritis of the thumb.

    • Melissa M Merritt, Toni S Roddey, Charles Costello, and Sharon Olson.
    • School of Physical Therapy, Texas Woman's University, Houston, Texas, USA. mmerritt@mail.st-joseph.org
    • J Hand Ther. 2010 Jul 1; 23 (3): 261-7; quiz 268.

    Study DesignClinical Measurement.IntroductionThumb carpometacarpal (CMC) osteoarthritis is a frequent cause of thumb pain.Purpose Of The StudyTo evaluate the interrater reliability and the criterion validity of the grind test for thumb CMC osteoarthritis.MethodsRadiological evaluation was used as the gold standard. Seventy thumbs of 54 persons with various hand disorders were included in the study. The grind test was performed by two physical therapists, and radiographs were evaluated by a certified hand surgeon, all blinded to the participants' diagnosis and other test results. Interrater reliability was compared with a kappa statistic, and the sensitivity, specificity, likelihood ratios, and predictive values were calculated from a 232 table.ResultsA kappa value of 0.48 was calculated as the interrater reliability. The sensitivity of the grind test was 42% and 53%, depending on tester. The specificity of the grind test was 80% and 93%, depending on tester. The positive likelihood ratio was 2.65 and 6.00, and the negative likelihood ratio was 0.59 and 0.62. The positive predictive value was 91% and 96%, depending on tester. The negative predictive value was 68% and 70%, depending on tester.ConclusionThe grind test has moderate reliability and accurately confirms the diagnosis of CMC osteoarthritis and identifies those who do not have CMC osteoarthritis. However, a negative grind test does not necessarily reflect negative radiographic evidence of thumb CMC osteoarthritis.Level Of Evidencen/a.Copyright © 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

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