Wrinkle Test (Shrivel Test) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing Peripheral Nerve Function (Sympathetic innervation).
- Used in children or uncooperative patients.
How to Perform
- Action: Place the patient's hand in warm water for 5-20 minutes.
Interpretation of Results
- Normal: Skin wrinkles (pruning).
- Positive: Skin remains smooth (denervated skin does not wrinkle).
Clinical Context & Limitations
The Wrinkle Test (Shrivel 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 Wrinkle Test (Shrivel Test) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
