Anatomical Snuffbox Tenderness Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Scaphoid Fracture.
How to Perform
- Position: Patient extends the thumb to define the snuffbox (between EPL and EPB tendons).
- Action: Examiner palpates firmly in the floor of the snuffbox.
Interpretation of Results
- Positive Test: Sharp, localized pain.
- Warning: High sensitivity; missed scaphoid fractures can lead to avascular necrosis.
Diagnostic Accuracy
- Sensitivity: 90-100%
Clinical Context & Limitations
The Anatomical Snuffbox Tenderness should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Anatomical Snuffbox Tenderness with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
