Wrist & Hand
TFCC & Impingement
Evidence: confirmed
Ulnar Fovea Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing TFCC Tears (specifically foveal disruptions).
How to Perform
- Position: Hand neutral.
- Action: Examiner presses deeply into the interval between the ulnar styloid process and the flexor carpi ulnaris tendon (the 'soft spot').
Interpretation of Results
- Positive Test: Reproduction of severe pain or tenderness.
- Note: High sensitivity (95%) for foveal disruptions.
Diagnostic Accuracy
- Sensitivity: 95%
- Specificity: 87%
Clinical Context & Limitations
The Ulnar Fovea Sign 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 Ulnar Fovea Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
