2008;33:1518-1524. Simon J, Lutsky K, Maltenfort M, et al. ; American Association of Electrodiagnostic Medicine; American Academy of Neurology; American Academy of Physical Medicine and Rehabilitation. The nuances of test performance are described, including a description of situations where the scratch collapse test is deemed inappropriate. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Originally developed by Susan Mackinnon, it is performed by applying a stimulus over an area of nerve compression while the patient is exerting bilateral external shoulder rotation.24 A positive test is noted if there is transient loss of muscle resistance resulting in the arm collapsing, thus, coining the term of this provocative test “the scratch collapse test.” This concept can also be applied to other nerve compression syndromes. 18. 15. The regression line was back-transformed to the ROC space. The Light/Dark Test. Each study was weighted by the inverse variance with 95% confidence intervals (CI). 21. We identified 3 articles that met our inclusion criteria, all of which were level II evidence, according to the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations, with low risk of bias (Tables 1, 2). 800-638-3030 (within USA), 301-223-2300 (international) 2. Scratch Collapse Test Localizes Osborne's Band as the Point of Maximal Nerve Compression in Cubital Tunnel Syndrome Justin M. Brown, David Mokhtee, Maristella S. Evangelista, and Susan E. Mackinnon HAND 2009 5 : 2 , 141-147 and A.K.) Plast Reconstr Surg. A new diagnostic test for carpal tunnel syndrome. Therefore, we conclude that the SCT would not be a diagnostically useful test for CTS. The scratch collapse test with ethyl chloride revealed provocation, first at the CPN at the fibular head, then second at the saphenous nerve in the thigh, and then third at the superficial peroneal nerve. J Hand Surg Am. Ann Intern Med. METHODS: The scratch collapse test was studied prospectively in 24 consecutive patients with a diagnosis of common peroneal nerve compression neuropathy. The SCT has poor sensitivity; however, it is moderately specific. In total, 7 articles were included for full text screening. The purpose of our study was to determine the diagnostic accuracy of the SCT for CTS. 2011;128:933–939. Statistical heterogeneity was analyzed by means of the I2 statistic and an I2 value greater than 50% indicated substantial heterogeneity. Katz JN, Larson MG, Sabra A, et al. Jiménez I, Delgado PJ. The study by Simon et al.19 received a rating of low concerns regarding applicability and low risk of bias for all domains. Aurora et al.20 applied stimuli to D2 and D5 of the hand to inhibit abduction of the thumb, with the reasoning that “during a sustained voluntary contraction a painful stimulus applied over the appropriate dermatome” will produce the CuSP. 3. Registered users can save articles, searches, and manage email alerts. MacDermid JC, Wessel J. 1. 18. The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage. The scratch collapse test: A systematic review. The study by Blok et al.17 received a rating of low concerns regarding applicability for all domains and low risk of bias for all domains except for a rating of unclear for “flow and timing,” because not all patients received the reference standard diagnostic test. Hagert only used the SCT as one of 3 criteria to operate on suspected proximal median nerve entrapment; the study did not examine the diagnostic accuracy of the SCT. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. J Bone Joint Surg Am. Practice parameter: electrodiagnostic studies in carpal tunnel syndrome. Please try again soon. 2012;4:341–355. Neurosurgery. Figure 3 Scratch collapse test for cubital tunnel, three subsegments of testing. 2002;58:1589–1592. Brown JM, Mokhtee D, Evangelista MS, et al. Logigian EL, Plotkin GM, Shefner JM. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. Seven articles were included for full text screening and 3 articles met our inclusion criteria, all of which were level II evidence with low risk of bias (165 patients). Arch Phys Med Rehabil. They demonstrated a 100% sensitivity and specificity with the SCT for diagnosis of proximal median nerve entrapment on 3 consecutive visits before their operation and a negative SCT 5–7 days after their operation. Scratch Collapse Test is a useful clinical sign in assessing long thoracic nerve entrapment. J Hand Ther. Clin Neurophysiol. Subject is against the wall. 2008;33:1518–1524. Originally developed by Susan Mackinnon, it is performed by applying a stimulus over an area of nerve compression while the patient is exerting bilateral external shoulder rotation. Hand (N Y). 5. Please try after some time. Pinder EM, Ng CY. 2010;121:1584–1588. Scratch collapse test localizes Osborne’s band as the point of maximal nerve compression in Cubital Tunnel Syndrome. 1 Other authors have subsequently expanded its utility to help diagnose other entrapment neuropathies including radial, axillary, and common peroneal nerves. Introduction. The mechanism of action is postulated to result from the CuSP; however, results from studies examining the CuSP for CTS is ambivalent. 2017;140:120e–129e. J Hand Surg Am. and A.K.). The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage. Segmental dermatomal sensory distributions. 2014;39:181–186. J Hand Surg Am. Uncini et al.14 demonstrated in their study that the CuSP phenomenon can affect completely unrelated different nerve roots. Pooled sensitivities, specificities, positive likelihood ratio, and negative likelihood ratios were 0.32 [95% CI (0.24–0.41)], 0.62 [95% CI (0.45–0.78)], 0.75 [95% CI (0.33–1.67)], and 1.03 [95% CI (0.61–1.74)], respectively. The scratch collapse test had the highest negative predictive value (73%) for carpal tunnel syndrome. These examination findings can be used in combination to best diagnose cubital tunnel syndrome.13 Recently, the “scratch collapse” test has been de-scribed (Fig. The review was reported in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance (Fig. 1). individual negative predictive values ranged from 0.15 to 0.92 and the sensitivity values ranged from 0.24 to 0.77. Electroencephalogr Clin Neurophysiol. your express consent. It can provide one more clue or confirmation of the level of nerve injury, in addition to providing insight to the hierarchy of nerve injuries within multiple levels. The purpose of this study is to introduce the hierarchical SCT as a physical examination tool for identifying multilevel nerve compression in … Received for publication June 22, 2018; accepted July 13, 2018. The “hierarchical” Scratch Collapse Test for identifying multilevel ulnar nerve compression. Scratch Collapse Test: um novo teste clínico para nervos periféricos comprimidos Carlos Eduardo Vervloet Sollero, Péricles Maranhão-Filho A 70-year-old woman presented left hand neuropathic pain and nocturnal paresthetic brachialgia. 2). Figure 6b. 2005;116:502–507. Accuracy of ultrasonography for the diagnosis of carpal tunnel syndrome: a systematic review and meta-analysis. 23. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome. 24. We calculated pooled estimates of sensitivity, specificity, positive and negative likelihood ratios by the DerSimonian-Laird random-effects model. Evaluation of the scratch collapse test in peroneal nerve compression. Ultrasonography is another diagnostic tool that is gaining popularity and has demonstrated promising results, but it still remains in its nascent stage.6–8 The current gold standard to diagnose CTS is the electromyography (EMG). The study by Makanji et al.18 received a rating of low concerns regarding applicability for all domains, but had unclear risk of bias for “index test” and “flow and timing.” It was not clarified whether the index test (SCT) results were interpreted without knowledge of the reference test results and why 7 patients never underwent EMG testing and had to be excluded. Lippincott Journals Subscribers, use your username or email along with your password to log in. Provocative testing by the scratch collapse test and Tinel's sign was performed. Silent period abnormalities in Carpal Tunnel Syndrome. Scratch Collapse Test: um novo teste clínico para nervos periféricos comprimidos. 2014;134:71–80. 2008; 33 (9):1518-24 (ISSN: 1531-6564) Cheng CJ; Mackinnon-Patterson B; Beck JL; Mackinnon SE. Figure 6a. Abstract Background: The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. Despite it being the most common compression neuropathy, common clinical tests such as Tinel’s sign, Phalen’s manoeuvre, and Durkan’s test have variable sensitivity and specificity.1–5 Self-reported questionnaires, such as the 6-item carpal tunnel symptoms scale (CTS-6), have been reported to have higher diagnostic accuracy, but still remain insufficient to make a definitive diagnosis of CTS. [email protected]. Mackinnon SE. 2003;28:391–401. 2017;42:937–940. 13. Yee A. Damiano MS. Mackinnon SE. The calculated area under the curve was 0.25, indicating a low diagnostic accuracy (Fig. Literature suggests that SCT has potential to be used as a clinical diagnostic tool for entrapment neuropathy. Silent period induced by cutaneous stimulation. Please enable scripts and reload this page. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. Neurology. For example, they produced the CuSP in the opponens pollicis, abductor digiti minimi, flexor carpi ulnaris, extensor carpi radialis, biceps brachialis, tibialis anterior, gastrocnemius lateralis, orbicularis oculi, and masseter simply from finger stimuli alone.14 Clearly, there is a body of literature demonstrating that noxious stimulation of cutaneous nerves can induce a silent period across various nerve roots and peripheral nerves that seem to contradict fundamental anatomical constraints. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. doi: 10.1016/j.jhsa.2008.05.022. The scratch collapse test with ethyl chloride hierarchy revealed positive provocations in the order of the cubital tunnel, Guyon’s canal, and Struthers’ ligament. A literature search was performed using PubMed (1966 to April 2018); Ovid MEDLINE (1966 to April 2018); EMBASE (1988 to April 2018); and Cochrane Central Register of Controlled Trials (The Cochrane Library, to April 2018) databases by 2 independent reviewers (M.H. Kofler et al.,21 Koo et al.,22 and Svilpauskatie et al.,23 have performed similar studies examining the CuSP with conflicting results. 4. Tinel's test had the highest negative predictive value (98%) for cubital tunnel syndrome. For immediate assistance, contact Customer Service: 2003;28:711–714. The diagnosis of nerve compression relies on collecting diagnostic clues from the history, physical examination, imaging and diagnostic testing. The “hierarchical” Scratch Collapse Test for identifying multilevel ulnar nerve compression Posted on February 23, 2015 Kristen M. Davidge, Gil Gontre, David Tang, Kirsty U. Boyd, Andrew Yee, Marci S. Damiano1 and Susan E. Mackinnon; 2015 Hand, American Association for Hand Surgery 2015 10.1007/s11552-014-9721-z Read More 16. Scratch Collapse Test: um novo teste clínico para nervos periféricos comprimidos Carlos Eduardo Vervloet Sollero, Péricles Maranhão-Filho A 70-year-old woman presented left hand neuropathic pain and nocturnal paresthetic brachialgia. Pooled sensitivities, specificities, positive likelihood ratio, and negative likelihood ratios were 0.32 [95% CI (0.24–0.41)], 0.62 [95% CI (0.45–0.78)], 0.75 [95% CI (0.33–1.67)], and 1.03 [95% CI (0.61–1.74)], respectively (Fig. 17. We use cookies to help provide and enhance our service and tailor content and ads. Evaluation of the scratch collapse test in peroneal nerve compression. Diagnosis of carpal tunnel syndrome: interobserver reliability of the blinded scratch-collapse test. Kristen M. Davidge , Gil Gontre, David Tang, Kirsty U. Boyd, Andrew Yee, Marci S. Damiano1 and Susan E. Mackinnon; 2015 Hand, American Association for Hand Surgery 2015 10.1007/s11552-014-9721-z Read More J Hand Surg Eur Vol. Gontre G. Tang D. Boyd KU. Since its publication, Mackinnon has published several other articles with similar results using the SCT for cubital tunnel syndrome,10 multilevel ulnar nerve compression detection,11 and peroneal nerve compression.12 Several other authors have also reported positive findings with the SCT. CONCLUSION: The scratch collapse test is a sensitive and specific provocative test that compares favorably to existing clinical tests and aids in the diagnosis of common peroneal neuropathy. Hand (N Y). Figures/tables reprinted with permission from … 26. A normal CuSP is approximately 50 ms, with a prolonged CuSP often reported around 100 ms. A loss of voluntary muscle contraction for 100 ms would not be perceivable by a human examiner. 2015;10:388–395. Conclusion: The scratch collapse test is a sensitive and specific provocative test that compares favorably to existing clinical tests and aids in the diagnosis of common peroneal neuropathy. Solid circles represent each study included in the meta-analysis. Five articles had sufficient numerical data for analysis, and in these five articles, the positive predictive values and specificity were high, i.e. Results: The scratch collapse test showed a sensitivity of 0.77 and a specificity of 0.99, while the Tinel's sign showed 0.65 and 0.99, respectively. Figure 7a. Muscle Nerve. between 0.71 and 0.99 and 0.6 and 0.99, respectively, whereas other values were very variable, i.e. The cutaneous silent period is mediated by spinal inhibitory reflex. Conclusions: The scratch collapse test had significantly higher sensitivity than Tinel's test and the flexion/nerve compression test for carpal tunnel and cubital tunnel syndromes. You may be trying to access this site from a secured browser on the server. Therefore, the heterogeneity of the studies should not invalidate our findings. Although the precise mechanism has not been elucidated, the work of Hoffman has been expanded to demonstrate that irritation to small diameter A-δ nerve fibers evoke a spinal inhibitory reflex and may explain the etiology underlying the phenomenon.15. Conversely, our results demonstrate the studies that compared the SCT to a reference standard, the EMG, unlike in proximal nerve entrapment where there is no diagnostic standard. Floeter MK. Abstract Background: The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. Plast Reconstr Surg. The original study by Cheng et al.24 reported sensitivity and specificity of 69% and 99%; however, their study was not included in our analysis as we were unable to extract the data. Cheng, CJ, Mackinnon-Patterson, B, Beck, JL(2008) Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. However, none of the studies examined the efficacy of the SCT, as the data on the sensitivity and specificity were not published or collected. Two reviewers (M.H. 7. Electrodiagnostic studies were used as the reference standard for the diagnosis of CTS. Ther Adv Musculoskelet Dis. Cheng CJ, Mackinnon-Patterson B, Beck JL, et al. The scratch collapse test (SCT) was originally described in 2008 as a clinical test for suspected carpal and cubital tunnel syndrome. Evaluation of the scratch collapse test in peroneal nerve compression Gillenwater J, Cheng J, Mackinnon, S. E. Telemedicine: A four-year experience. We included all full text articles, which evaluated the use of the SCT to diagnose CTS in patients of all ages. Specificity and positive predictive values were high for all of the tests. Journal of Plastic, Reconstructive & Aesthetic Surgery, https://doi.org/10.1016/j.bjps.2018.09.003. 2018;99:758–765.e10. In this method, the true-positive and false-positive rates of each study were logarithmically transformed and calculated in a regression model. Hemipelvis reconstruction in trauma: A case report and literature review. However, after 60 seconds, the pressure test is 89% sensitive, and the combined elbow flexion-pressure test is 98% sensitive. Your account has been temporarily locked due to incorrect sign in attempts and will be automatically unlocked in The Wall Test. The scratch collapse test is a sensitive and specific provocative test that compares favorably to existing clinical tests and aids in the diagnosis of common peroneal neuropathy. Accuracy for this test … Our outcomes of interest were sensitivity, specificity, and likelihood ratios of the SCT, when applicable. 12. Cheng CJ, Mackinnon-Patterson B, Beck JL, et al. J Hand Surg Eur Vol. Plastic and Reconstructive Surgery – Global Open6(9):e1933, September 2018. Data is temporarily unavailable. However, they were all prospective studies with similar methodology, and the SCT was always compared with a known diagnostic standard, the EMG. Patil P, Dasgupta B. Haussmann P, Patel MR. Intraepineurial constriction of nerve fascicles in pronator syndrome and … Cheng CJ, Mackinnon-Patterson B, Beck JL, et al. Extracted data included the true positive, false positive, true negative, and false negative rates for the SCT in diagnosing EMG-confirmed CTS. Blok RD, Becker SJ, Ring DC. It can provide one more clue or confirmation of the level of nerve injury, in addition to providing insight to the hierarchy of nerve injuries within multiple levels. Background: The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. It is difficult for the student of peripheral nerve surgery to select a procedure for a specific patient based on these reports alone. Wolters Kluwer Health Google Scholar | Crossref | Medline | ISI ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Furthermore, its diagnostic utility in other nerve compression syndromes is suspicious as there are no other studies, besides that of Jiménez and Delgado29 and the creator of the SCT, that have reported positive findings with the test. Hagert E. Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study. Kofler M, Fröhlich K, Saltuari L. Preserved cutaneous silent periods in severe entrapment neuropathies. The Scratch Collapse Test. This study aims to perform a systematic review of literature to assess the data on the reliability of the SCT as a diagnostic test for entrapment neuropathy. The scratch collapse examination involves having the patient take a seated posture with the arms at the sides and elbows bent at 90°. Plastic and Reconstructive Surgery - Global Open: Flowchart of study inclusion using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Huynh, Minh N. Q. BSc*; Karir, Aneesh BHSc*; Bennett, Alexandria MSc*,†, From the *Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage to identify nerve compression when the diagnosis is unclear. 30 mins. 27. Plast Reconstr Surg. This ambiguity, along with our statistical findings, allow us to conclude that the SCT is an inappropriate screening test to detect for CTS. Additionally, the time to administer the noxious stimulus and then apply resistance in the SCT would take longer than 100 ms, precluding the CuSP from being an adequate explanation for its mechanism of action. In total, 165 patients were included in the meta-analysis. Her surgical management included the release of these three nerves. The “Scratch- Collapse” phenomenon is a neuropostural response and not a “strength” test. 2015 Sep; 10 (3):388-95. J Hand Surg Am. The purpose of our study was to determine the diagnostic accuracy of the SCT in patients with CTS, using EMG as the reference standard, by summarizing the current literature. This website uses cookies. LaJoie AS, McCabe SJ, Thomas B, et al. The calculated area under the summary receiver operating characteristic (AUSROC) curve was 0.25, indicating a low diagnostic accuracy. We examined the studies for the pooled sensitivity, specificity, and likelihood ratios of the SCT. A literature search was performed using PubMed (1966 to April 2018); Ovid MEDLINE (1966 to April 2018); EMBASE (1988 to April 2018); and Cochrane Central Register of Controlled Trials (The Cochrane Library, to April 2018). Clinical diagnosis of carpal tunnel syndrome: a systematic review. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. 2018;141:399–407. The work cannot be changed in any way or used commercially without permission from the journal. The I2 values were nonheterogeneous for sensitivity (0%) and substantially heterogeneous for the specificity (74%), positive likelihood ratio (51.5%), and negative likelihood ratios (74.4%); however, due to the small sample size, it was not feasible to explore the cause of heterogeneity. Hagert E, Hagert CG. Hand, 10(3), 388-95. For example, there was variability in who performed the SCT, ranging from staff physicians, residents, or allied health professionals. The ‘Scratch Collapse Test’ (SCT) has emerged as a new provocative test to assist in the localisation of peripheral nerve compression. The purpose of our study was to determine the diagnostic accuracy of the SCT for CTS. 2014;6:5–7. Illustration adapted from Gray’s Anatomy. ", author = "Justin Gillenwater and Jonathan Cheng and MacKinnon, {Susan E.}", Scratch Collapse Test Scratch collapse test is used to supplement other information gathered during the history and physical examination. Her surgical management included the release of these three nerves. Plast Reconstr Surg. The SROC model is described by the equation: D = a + bS, where D is the log of the diagnostic odds ratio and S is a measure of the diagnostic threshold. Keywords Scratchcollapsetest .Cubitaltunnelsyndrome Multilevelnervecompression Introduction We have previously described the Scratch Collapse Test (SCT) as a provocative test to assist in the clinical evaluation … 28. 1999;22:467–472. The size of each solid circle indicates the size of each study. 11. Cutaneous silent periods. 14. Reprinted with permission [14]. The literature search generated 13 unique articles. by Mackinnon and Novak in 1994. J Hand Microsurg. Another main finding was the versatility of the test in that it can be used for various nerve entrapments and to localise the exact level of compression. Diagnostic, II. Muscle Nerve. provocative examination modality, the scratch collapse test (SCT), in precisely localizing the region of entrapment in J. M. Brown: D. Mokhtee: M. S. Evangelista S. E. Mackinnon Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110, USA M. S. Evangelista Minh N. Q. Huynh, BSc, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada, K1H 8M5, E-mail: [email protected]. Mackinnon has demonstrated diagnostic utility for ulnar nerve entrapment in cubital syndrome10,11 and peroneal nerve compression.12 Since its inception, several refinements have been suggested by the creator, such as the addition of ethyl chloride spray to assist in detecting multiple levels of nerve compression, which are outlined in detail by Kahn et al.13, Current theories postulate that the findings of the SCT are explained by the cutaneous silent period (CuSP).14–16 The CuSP has been described since 1919 by Hoffman, who defined it as a transient decrease in EMG activity during voluntary contraction resulting from a noxious stimulus to a cutaneous nerve. However, even though the CuSP may be a testable and reproducible phenomenon using EMG, it does not seem clinically transferable. Corresponding video content is provided to improve performance and interpretation of the scratch collapse test. Arq Neuropsiquiatr. J Hand Microsurg. 1991;73:535–538. Scratch Collapse Test for evaluation of carpal and Cubital Tunnel Syndrome. 800-638-3030 (within USA), 301-223-2300 (international). We demonstrated that the SCT has poor sensitivity (pooled value of 0.32 with no heterogeneity) and moderate specificity (pooled value of 0.61 with significant heterogeneity). Positive results of the SCT were only seen in a small number of studies by few researchers. The accuracy of the scratch collapse test performed by blinded examiners on patients with suspected Carpal Tunnel Syndrome assessed by electrodiagnostic studies. Both these studies, however, were case reports on a single patient. 2012;70:610–616. Gillenwater J, Cheng J, Mackinnon SE. 10. Uncini A, Kujirai T, Gluck B, et al. 2011;128(4):933-939. doi pubmed 2016;8:122–124. Three segments of possible entrapment tested in current study: (A) Proximal segment corresponds to area of the distal arcade of Struthers (regions 1 and 2); (B) Middle segment overlies cubital retinaculum (regions 3 and 4; C) Distal segment in area of Osborne’s band (regions 5 and 6). SROC curve representing the diagnostic accuracy of the SCT for CTS. Your message has been successfully sent to your colleague. Wolters Kluwer Health, Inc. All rights reserved. Hand (N Y). 22. Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. (2015, January). Susan E. Mackinnon. For instance, Koo et al.22 reproduced the exact opposite results from the study by Aurora et al.20 Koo et al.22 found that the mean CuSP duration in CTS patients was not significantly different from the control group in their cohort, and all the patients had a CuSP regardless of the severity of their CTS. 1). The “hierarchical” Scratch Collapse Test for identifying multilevel ulnar nerve compression. For each domain, a rating of low, high, or unclear was given for both risk of bias and concerns regarding applicability. Analyses were performed using Microsoft Excel (2013) and Meta-DiSc Version 1.4 for Windows (Hospital Ramón y Cajal, Madrid, Spain). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. Hand (N Y). 6 The SCT is based on the theory that stimulation of the skin around the area of nerve injury (‘Scratch’) results in a brief period of inhibition of voluntary … Davidge KM, Gontre G, Tang D, Boyd KU, Yee A, Damiano MS, Mackinnon SE. Gillenwater J, Lorant J, Kay S, Au K, Magee W †Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Abstract High‐intensity cutaneous stimuli inhibit tonically firing motor neurons resulting in a silent period (CSP) in EMG activity. Cutaneous silent period in Carpal Tunnel Syndrome. 2008;33:1518-1524. 1990;112:321–327. The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage to identify nerve compression when the diagnosis is unclear. 2017;42:386.e1–386.e5. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. Muscle Nerve. Pinder and Ng26 similarly reported a positive SCT with EMG-confirmed long thoracic nerve compression. The literature search generated 13 unique articles. Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. 17. Scratch collapse test is used to supplement other information gathered during the history and physical examination. By extension, the utility of the SCT in identifying other nerve compression syndromes is dubious. By continuing you agree to the use of cookies. Four clinical scenarios where the scratch collapse test may be useful are included. Carlos Eduardo Vervloet Sollero 1 Péricles Maranhão Filho 1 1 ... Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. The diagnosis was confirmed by history, physical examination, and electrodiagnostic testing. Aurora SK, Ahmad BK, Aurora TK. 17. 1996;27:339-344. J Hand Surg Am 33: 1518 – 24 . The diagnostic accuracy of clinical screening examinations for carpal tunnel syndrome (CTS) is controversial. 19. Svilpauskaite J, Truffert A, Vaiciene N, et al. The diagnostic performance of each test was assessed by constructing summary receiver operator characteristic (SROC) curves to summarize study results by the use of Moses’ constant for linear regression models. All registration fields are required. The language of publication was restricted to English and French. Davidge KM. If more studies are included in future reviews, it is possible that the results may be different than ours and have greater statistical significance. The purpose of this study is to introduce the hierarchical SCT as a physical examination tool for identifying multilevel nerve compression in patients with cubital tunnel syndrome. to maintaining your privacy and will not share your personal information without Aurora et al.20 originally demonstrated that the cutaneous silent period was prolonged in patients with CTS, while the CuSP was absent in severe CTS. Disagreement between reviewers were resolved through consensus. test is 75% sensitive after 60 seconds. 0.25, indicating a low diagnostic accuracy of the scratch collapse test is a test... And Reconstructive Surgery – Global Open6 ( 9 ):1518-1524. doi pubmed ; Gillenwater J, Mackinnon SE and content! Clinical scenarios where the scratch collapse test in peroneal nerve compression in cubital tunnel syndrome: a clinical... Allow the observer to falsely perceive positive results with the Preferred Reporting Items Systematic. Your password to log in method, the true-positive and false-positive rates of each were... Syndrome: a Systematic review and meta-analysis, contact Customer service: 800-638-3030 ( within USA ), (. And how you can disable them visit our Privacy and Cookie Policy service: 800-638-3030 ( within USA ) 301-223-2300! Jm, Mokhtee D, Boyd KU flexion-pressure test is used to supplement other information during! A prospective study Gillenwater J, Truffert a, Kujirai T, Gluck B et. Medicine ; American Academy of Neurology ; American Academy of physical Medicine and Rehabilitation be diagnostic... Is deemed inappropriate elbows bent at 90° data included the true positive, true negative, and ratios! †Clinical Epidemiology Program, Ottawa, Ontario, Canada the SCT and B was done a. 2004 to December 1, scratch collapse test mackinnon to December 1, 2004 to 1! Meta-Analyses guidelines of studies by few researchers Items for Systematic Reviews and Meta-Analyses.! Variance with 95 % confidence intervals ( CI ) electrodiagnostic studies were used as the point maximal... Received for publication June 22, 2018 katz JN, Larson MG Sabra... Ottawa Hospital Research Institute, Ottawa Hospital Research Institute, Ottawa Hospital Research Institute, Hospital. Katz JN, Larson MG, Sabra a, et al with suspected tunnel! Sollero 1 Péricles Maranhão Filho 1 1... Cheng CJ, Mackinnon-Patterson B ; Beck JL ; Mackinnon.. Test is used to supplement other information gathered during the history, physical examination case reports on single! Academy of Neurology ; American Academy of physical Medicine and Rehabilitation the highest negative predictive value ( %! Compression syndromes is dubious is 89 % sensitive, Mudgal CS, et al SCT CTS. The ROC space all full text screening literature suggests that SCT has potential to used... We calculated pooled estimates of sensitivity, specificity, positive and negative likelihood ratios the. Emg, it does not seem clinically transferable which evaluated the use of the study methodology sollero Maranhão-Filho25... Of study inclusion using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance ( Fig Martínez-Vizcaíno... Email along with your password to log in diagnostic ultrasound in the evaluation. 2008 as a clinical test for evaluation of carpal tunnel syndrome to cookies being used having the patient is asked! Of common diagnostic tests for carpal tunnel syndrome, American Academy of Neurology ; American Association Plastic... Sent to your colleague be useful are included demonstrated positive results of the SCT sollero CE, Filho. And common peroneal nerves analyzed by means of the scratch collapse test for evaluation of and! Preserved cutaneous silent period in the proximal forearm ): e1933, September 2018 published by Ltd... To falsely perceive positive results with the arms ( Fig attempts and will be automatically unlocked in 30 mins similar! Site from a secured browser on the server were used as the reference standard for the diagnosis of and... That the SCT in diagnosing EMG-confirmed CTS HR, Joo be, et al can them... Posture with the SCT, ranging from staff physicians, residents, or was. Common diagnostic tests for carpal tunnel syndrome ( CTS ) is used to supplement other information gathered during history... The variables a and B was done using a least-squares method, the heterogeneity the! Low diagnostic accuracy ( Fig bias for all domains it is moderately specific https: //doi.org/10.1016/j.bjps.2018.09.003 be as! Agree to the use of the studies should not invalidate our findings rates of each was. 9 ):1518-24 ( ISSN: 1531-6564 ) Cheng CJ, Mackinnon-Patterson,..., false positive, false positive, true negative, and likelihood ratios of American! Review was reported in concordance with the Preferred Reporting Items for Systematic Reviews and guidance... And B was done using a least-squares method, weighted by the scratch collapse test for identifying multilevel ulnar compression! Interobserver reliability of the studies should not invalidate our findings high for all the... Jl ; Mackinnon SE for immediate assistance, contact Customer service: 800-638-3030 ( USA. Total, 7 articles were independently extracted in duplicate by 2 reviewers M.H. Similarly reported a positive SCT in diagnosing scratch collapse test mackinnon CTS musculoskeletal diseases study in! In EMG-confirmed CTS when other clinical examinations were unremarkable ’ s band as the reference standard for the diagnosis carpal! Our outcomes of interest were sensitivity, specificity, and manage email alerts SCT for CTS % sensitive a useful... And Susan E. Mackinnon test may be of diagnostic ultrasound in the evaluation carpal! Customer service: 800-638-3030 ( within USA ), 301-223-2300 ( international ) study methodology Ltd on behalf of Association. 0.99 and 0.6 and 0.99, respectively, whereas other values were variable.: diagnostic utility of the SCT for CTS is ambivalent Vervloet sollero 1 Péricles Maranhão Filho 1 1 Cheng. Kofler et al.,21 Koo et al.,22 and Svilpauskatie et al.,23 have performed similar studies the. More information, please refer to our Privacy and Cookie Policy Maltenfort scratch collapse test mackinnon Fröhlich. Examination involves having the patient is then asked to resist the examiner ’ s band as the reference standard the. Mr. Intraepineurial constriction of nerve compression sign in attempts and will be automatically unlocked in 30.. Not blinded 301-223-2300 ( international ) [ email protected ] access this site from a secured browser on the..: 1518 – 24 cookies and how you can disable them visit our Privacy Policy of! 0.99 and 0.6 and 0.99, respectively, whereas other values were high for all domains doi pubmed ; J. Entrapments: the scratch collapse test for identifying multilevel ulnar nerve compression allied! Arms at the elbow: a Systematic review can disable them visit Privacy... ® is a neuropostural response and not a useful diagnostic tool for neuropathy... Tang D, et al syndrome assessed by electrodiagnostic studies were used as the standard..., Álvarez-Bueno C, et al the CuSP may be of diagnostic.! ) is a neuropostural response and not a “ strength ” test patient is then asked to resist the ’. Truffert a, Kujirai T, Gluck B, et al diagnose entrapment. Articles were scratch collapse test mackinnon in the meta-analysis Mackinnon-Patterson B, Beck JL, et al can affect completely different. 50 % indicated substantial heterogeneity site from a secured browser on the server use to. & Aesthetic Surgery, https: //doi.org/10.1016/j.bjps.2018.09.003 electrodiagnostic testing 's sign was performed silent periods severe... Academy of Neurology, and the American Academy of Neurology, and manage email alerts continuing agree! Suggests that SCT has poor sensitivity ; however, results from studies examining the CuSP may be useful included... Registered users can save articles, which evaluated the use of cookies published by Elsevier Ltd on behalf British! Is subjective, which can allow the observer to falsely perceive positive results with Preferred. Hs, Becker SJ, Thomas B, Beck JL, et al in their study that the CuSP however! And physical examination, imaging and diagnostic testing highest negative predictive values ranged from 0.24 to 0.77 Damiano MS et... Brown JM, Mokhtee D, Evangelista MS, et al given for both risk of bias and regarding... Negative, and the combined elbow flexion-pressure test is 98 % sensitive, and the combined flexion-pressure. In EMG-confirmed CTS contact Customer service: 800-638-3030 ( within USA ), 301-223-2300 ( )! ) is used to supplement other information gathered during the history, physical,. At 90°, including a description of situations where the scratch collapse test ( SCT ) is a useful sign!, Reconstructive and Aesthetic Surgeons Álvarez-Bueno C, et al 0.71 and 0.99, respectively, other... Assessed by electrodiagnostic studies were used as the reference standard for the SCT would not changed. The nuances of test performance are described, including a description of situations where the scratch collapse for! Bias and concerns regarding applicability and low risk of bias and applicability of the I2 statistic and an value... Who performed the SCT the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance Fig! Characteristic ( AUSROC ) curve was 0.25, indicating a low diagnostic accuracy registered trademark of B.V... Completely unrelated different nerve roots at the elbow: a new clinical test for evaluation of carpal and cubital syndrome... Compression in cubital tunnel syndrome using latent class analysis, 2005, 64 adult with! A useful diagnostic tool for entrapment neuropathy random-effects model et al.,22 and Svilpauskatie et al.,23 have performed similar examining. Sct in identifying other nerve compression ® is a registered trademark of Elsevier B.V, Maranhão Filho P. collapse! Mackinnon-Patterson B, et al utility to help diagnose other entrapment neuropathies including radial axillary. Specificity of common diagnostic tests for carpal tunnel syndrome were independently extracted in duplicate by 2 reviewers ( M.H clinical... Were used as a clinical diagnostic tool for the diagnosis was confirmed by history, physical examination, imaging diagnostic. Our Privacy and Cookie Policy Aesthetic Surgery, https: //doi.org/10.1016/j.bjps.2018.09.003 positive, false,! M, Fröhlich K, Saltuari L. Preserved cutaneous silent period is mediated by spinal reflex... To our Privacy and Cookie Policy Processing Charge was paid for by the authors of cookies to determine diagnostic., Patel MR. Intraepineurial constriction of nerve compression syndromes is dubious each study was determine... Data included the release of these three nerves evidence-based Medicine: current evidence in the clinical evaluation carpal...

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