Wrist & Hand
Bone & Joint
Evidence: suggestive
Murphy's Sign (Lunate) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Lunate Dislocation.
How to Perform
- Action: Patient makes a fist.
- Observation: Examiner looks at the level of the 3rd metacarpal (middle knuckle).
Interpretation of Results
- Normal: The 3rd knuckle projects higher than the 2nd and 4th.
- Positive: The 3rd knuckle is level with the others (it has "dropped").
Clinical Context & Limitations
The Murphy's Sign (Lunate) 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 Murphy's Sign (Lunate) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
