Wrist & Hand
Instability
Evidence: uncertain
Lichtman Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Midcarpal Instability.
How to Perform
- Action: Examiner stabilizes the forearm and moves the wrist from Radial Deviation to Ulnar Deviation while applying an axial load.
Interpretation of Results
- Positive Test: A palpable "clunk" or jump as the proximal row shifts from flexion to extension.
Clinical Context & Limitations
The Lichtman Test 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 Lichtman Test with complementary examination tests significantly improves overall diagnostic confidence.
