Wrist & Hand
TFCC & Impingement
Evidence: uncertain
TFCC Load Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Triangular Fibrocartilage Complex (TFCC) tears.
How to Perform
- Position: Patient's wrist in ulnar deviation.
- Action: Examiner applies an axial compressive load and rotates the forearm (grinding the carpus against the TFCC).
Interpretation of Results
- Positive Test: Pain, clicking, or crepitus on the ulnar side of the wrist.
Diagnostic Accuracy
- High sensitivity for peripheral tears.
Clinical Context & Limitations
The TFCC Load 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 TFCC Load Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
