Gamekeeper's Test (UCL Stress) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Ulnar Collateral Ligament (UCL) tears of the thumb (Skier's Thumb).
How to Perform
- Action: Apply a valgus stress (pushing thumb outward) to the MCP joint.
- Positions: Test in both full extension and 30° of flexion.
Interpretation of Results
- Positive Test: Laxity >30° or lack of a firm end-feel compared to the healthy side.
Clinical Context & Limitations
The Gamekeeper's Test (UCL Stress) 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 Gamekeeper's Test (UCL Stress) with complementary examination tests significantly improves overall diagnostic confidence.
