Semmes-Weinstein Monofilament Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- The Gold Standard for testing cutaneous pressure threshold (Protective Sensation).
How to Perform
- Action: Examiner presses a monofilament (usually 2.83 or 5.07) against the fingertip until it bends.
- Response: Patient says "Yes" when they feel the touch (eyes closed).
Interpretation of Results
- Green (2.83): Normal sensation.
- Blue (3.61): Diminished light touch.
- Purple (4.31): Diminished protective sensation.
- Red (6.65): Loss of deep pressure sensation.
Clinical Context & Limitations
The Semmes-Weinstein Monofilament 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 Semmes-Weinstein Monofilament Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
