Wrist & Hand Assessment

Watson Test | Scaphoid Shift Test | Scapholunate Instability Assessment

Buying options
Watson Test

Watson Test | Scaphoid Shift Test | Scapholunate Instability Assessment

The scapholunate ligament is a strong ligament between the scaphoid and the lunate and an important stabilizer of the wrist. It can be injured by a fall or a sudden load on the wrist and can occur together with a distal radius fracture or a carpal fracture. When untreated an SL tear can lead to a so-called DISI which stands for dorsal intercalated segmental instability, which is a dissociation of the scaphoid and lunate.

According to a review of Valdes et al. In the year 2013, the Watson Test has a positive mean likelihood ratio of 2.76 and a negative mean likelihood ratio of 0.25. This means that this test has a moderate clinical value to rule out SL ligament tears, but a low value to confirm an SL tear.

To perform the Watson Test your patient is in sitting position with his elbow supported on the treatment bench and facing the examiner. Then fixate your patient’s radius with one hand and give pressure on the palmar prominence of the scaphoid with your thumb into dorsal direction. The other hand grasps the patient’s metacarpals from the ulnar side to control the wrist position.
Start in ulnar deviation and slight extension. In this position, the long axis of the scaphoid is nearly in line with the axis of the radius.
Then move the wrist into radial deviation and slight flexion, while you keep the pressure on the scaphoid. Because the scaphoid wants to move into flexion with radial deviation, the oppositional force of the thumb will cause it to shift or subluxation in dorsal direction in case of an SL ligament rupture. When the pressure of the thumb is released, the scaphoid often shifts back in palmar direction with a “thunk”.

So this test is positive for an SL ligament rupture if such a thunk can be felt or heard or if it reproduces the patient’s familiar wrist pain on the dorsal side.
In a healthy wrist, the movement into radial deviation will either just be limited, or the scaphoid just pushes the thumb away in palmar direction.

Other common tests to assess instability of the wrist:

 

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

Physiotutors Free Assessment E-book

 

References

Valdes K, LaStayo P. The value of provocative tests for the wrist and elbow: a literature review. Journal of hand therapy. 2013 Jan 1;26(1):32-43.

LIKE WHAT YOU’RE LEARNING?

BUY THE FULL PHYSIOTUTORS ASSESSMENT BOOK

  • 600+ Pages e-Book
  • Interactive Content (Direct Video Demonstration, PubMed articles)
  • Statistical Values for all Special Tests from the latest research
  • Clinical Value Recommendation
  • Detailed descriptions & searchable
  • Currently on Version 4.0 – Free lifetime updates
  • And much more!
E-Book

ALL ORTHOPEDIC TESTS IN ONE PLACE

SEE ALL PRODUCTS
Assessment app banner
Assessment E-book
Reviews

What customers have to say about the Assessment E-Book

  • Kangmin Lee Avatar
    Kangmin Lee
    15/09/20

    The Assessment E-Book This is amazing book for health professions & students

    Janine Doe Avatar
    Janine Doe
    14/08/20

    The Assessment E-Book The book is fantastic. A great acquisition for all professionals because it presents all information in a concise, clear and grouped way.

    As I said earlier I would like to be able to access the material on all my devices.

  • Vince1992 Avatar
    Vince1992
    25/04/20

    The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!

    Simon Pagitz Avatar
    Simon Pagitz
    06/04/20

    The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
    Great work, guys

  • Angel10 Avatar
    Angel10
    27/11/19

    The Assessment E-Book (Spanish Version) Excelente Libro electrónico, me gusta que esta basado en la evidencia clínica y me apoya mucho para mi practica clínica. Es el mejor libro que he visto de evaluación, y me gusta mucho que esta en constante actualización, estaría bien meter más evaluaciones funcionales, que ya comienzan a subir en los videos con la nueva integrante mujer al equipo. Gracias kai y Andreas.

    혁 이 Avatar
    혁 이
    17/11/19

    The Assessment E-Book I can’t believe this extremely inconvenience interface of this book. I’m used to reading my physio books with kindle, ipad just swiping the page back and forth, but this book , you need to tap the arrow on the left corner of the book to turn the page..even space bar and enter key don’t work to turn the page..it’s feel like read a book in the computer in 1990s..

  • Jordi Burrut Avatar
    Jordi Burrut
    27/10/19

    The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!

    Roel Rademaker Avatar
    Roel Rademaker
    02/10/19

    The Assessment E-Book Very helpful during my study and making clinical decisions. You have made the test descriptions perfect for every region! Compliments! Loving the extra information (screening/guidelines) that comes with the cervical spine and the lumbar spine. Looking forward to see those as well for the other regions.

  • Manel Avatar
    Manel
    01/08/19

    The Assessment E-Book (Spanish Version) Un libro genial!!! Pero le doy 4 estrellas en vez de 5 ya que no me gusta el poder abrirlo solo en dos dispositivos. Tengo 2 ordenadores (uno en el trabajo), un móvil y una tablet, pudiendo abrirlo solo en dos de ellos. Por lo demás, un libro muy recomendable.

    Josh Avatar
    Josh
    07/07/19

    The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.

  • Julia Hauser
    12/06/19

    The Assessment E-Book These are probably the best 80€ that I have ever invested in a book. Absolutly greatful for your work. It has been such a great effort, that you have put into this book and together with your videos, it really helped me to pass some exams and to later decide which assessment to use for my patients. I can only recommend this book to every single physiotherapist or physio student!!!
    thumps up, guys

    Polo_soa Avatar
    Polo_soa
    15/02/19

    The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
    Congrats guys you’ve done an incredible job.
    I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
    In one word: amazing. Keep going guys ! Best wishes from france.

  • VCocho Avatar
    VCocho
    02/01/19

    The Assessment E-Book Congrats ! It’s an amazing work ! A great book you have to work with: on a computer & on my iPad, at home and at work ! Links with articles and videos are fabulous !
    Thank you very much & long life to Physiotutors !

    dominicledinger Avatar
    dominicledinger
    31/12/18

    The Assessment E-Book A must-have for every pt in this field! Excellent content that is absolutely worth the price. As you can use the ebook on two different devices, you can have it on your (work) computer and your phone.

  • Simon Busk Avatar
    Simon Busk
    01/12/18

    The Assessment E-Book Got me through my assessment exams with a breeze would not have been as easy and enjoyable without the assessment handbook. It provides relevant data, and insights into statistical values and the lay of the land on the research side of things. A great book and a must for any physiotherapist, student, or practitioner...

    Marios Pan Avatar
    Marios Pan
    30/10/18

    The Assessment E-Book Very good book to easily find relevant tests and their clinical value. I would recommend it for everyone in the Musculoskeletal or Sports Medicine field.

  • Facundo Avatar
    Facundo
    20/09/18

    The Assessment E-Book -

Wait before you go!LEARN TO TREAT THE MOST COMMON CAUSE OF VERTIGO

In this FREE video series by 
Vestibular Rehab Specialist
FIRAT KESGIN