Lunotriquetral Ballotement Test / Shuck Test | Lunotriquetral Ligament Assessment

Lunotriquetral Ballotement Test also known as Shuck Test is an orthopedic test to assess for lunotriquetral ligament injuries.

While most commonly the SL ligament and TFCC are affected in wrist ligament injuries, the wrist is a complex region and requires a thorough assessment as missed ligament injuries may result in persistent pain, instability, reduced grip force and range of motion and could lead to, early, osteoarthritis. Prosser et al. in (2011) evaluated the Lunotriquetral Ballottement Test or Shuck Test on its diagnostic accuracy and report a positive likelihood ratio of 1.03 and negative likelihood ratio of 0.8 when compared with arthroscopy findings which result in a weak clinical value.

To conduct the LT test, the patient is in sitting position and the forearm and hand are placed on the treatment table. The test is a dorsopalmar shear test. So the fingers of one hand locate and grab the lunate and the fingers of the other hand grab the adjacent triquetrum. Then you fixate the lunate and perform a dorsopalmar glide of the triquetrum.

A positive test indicates noticeable laxity compared to the unaffected hand as well as the reproduction of the patient’s painful symptoms.

Other common tests to assess instability of the wrist:

• Watson Test (for Scapholunate Ligament Injuries)
• Midcarpal Test
• DRUJ Test (Distal Radioulnar Joint Instability)

Prosser, R., Harvey, L., LaStayo, P., Hargreaves, I., Scougall, P., & Herbert, R. D. (2011). Provocative wrist tests and MRI are of limited diagnostic value for suspected wrist ligament injuries: a cross-sectional study. Journal of physiotherapy, 57(4), 247-253.