Thumb CMC Grind Test

 Thumb CMC Grind Test

What is Thumb CMC Grind Test?

Thumb CMC Grind Test is used to assess the osteoarthritis in the carpometacarpal joint of the thumb.

How it’s Performed?

Thumb CMC Grind Test
Thumb CMC Grind Test

What does a positive Thumb Grind Test mean?

Sensitivity & Specificity

A study1 found that The grind test has a low sensitivity and a high specificity, that make it as of limited diagnostic value:

Thumb CMC

Thumb carpometacarpal joint (also termed basal joint or CMC joint) .

Up to 50% of patients with thumb CMC osteoarthritis also have carpal tunnel syndrome.

CMC joint

Eaton and Littler staging for CMC joint arthritis:

STAGE DESCRIPTION
Type INormal-appearing joint with the exception of possible widening from synovitis
Type IIJoint space narrowing, with debris and osteophytes < 2 mm
Type IIIJoint space narrowing, with debris and osteophytes 2 mm
Type IVJoint space narrowing of scaphotrapezial and trapeziometacarpal articulations
Eaton Radiographic Stages of thumb CMC osteoarthritis

Most commonly performed procedure for advanced thumb CMC osteoarthritis is trapezium excision with ligament reconstruction and tendon interposition.

Eaton Radiographic Stages of thumb CMC osteoarthritis
Eaton Radiographic Stages of thumb CMC osteoarthritis

Reference

  1. Zina Model, Andrew Y. Liu, Lana Kang, Scott W. Wolfe, Jayme C. Burket, and Steve K. Lee: Evaluation of Physical Examination Tests for Thumb Basal Joint Osteoarthritis. Hand (N Y). 2016 Mar; 11(1): 108–112. PMID: 27418899
  2. Waggy C: Disorders of the wrist. In: Wadsworth C, ed. Orthopaedic Physical Therapy Home Study Course – The Elbow, Forearm, and Wrist. La Crosse, WI: Orthopaedic Section, APTA, Inc., 1997.
  3. Swanson A: Disabling arthritis at the base of the thumb: Treatment by resection of the trapezium and flexible implant arthroplasty. J Bone Joint Surg Am 54A:456, 1972.
  4. Green DP et al, editors: Green’s operative hand surgery, ed 6, Philadelphia, 2011, Churchill Livingstone, p 409.
  5. Clinical Tests for the Musculoskeletal System 3rd Edition.
  6. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.

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