Diagnostic Value of Clinical Grind Test for Carpometacarpal Osteoarthritis of the Thumb
published online 10 May 2010.
Abstract
Study Design
Clinical Measurement.
Introduction
Thumb carpometacarpal (CMC) osteoarthritis is a frequent cause of thumb pain.
Purpose of the Study
To evaluate the interrater reliability and the criterion validity of the grind test for thumb CMC osteoarthritis.
Methods
Radiological evaluation was used as the gold standard. Seventy thumbs of 54 persons with various hand disorders were included in the study. The grind test was performed by two physical therapists, and radiographs were evaluated by a certified hand surgeon, all blinded to the participants' diagnosis and other test results. Interrater reliability was compared with a kappa statistic, and the sensitivity, specificity, likelihood ratios, and predictive values were calculated from a 232 table.
Results
A kappa value of 0.48 was calculated as the interrater reliability. The sensitivity of the grind test was 42% and 53%, depending on tester. The specificity of the grind test was 80% and 93%, depending on tester. The positive likelihood ratio was 2.65 and 6.00, and the negative likelihood ratio was 0.59 and 0.62. The positive predictive value was 91% and 96%, depending on tester. The negative predictive value was 68% and 70%, depending on tester.
Conclusion
The grind test has moderate reliability and accurately confirms the diagnosis of CMC osteoarthritis and identifies those who do not have CMC osteoarthritis. However, a negative grind test does not necessarily reflect negative radiographic evidence of thumb CMC osteoarthritis.
Level of Evidence
n/a
School of Physical Therapy, Texas Woman's University, Houston, Texas
St. Joseph Rehabilitation Center, Bryan, Texas
School of Physical Therapy, Texas Woman's University, Houston, Texas
School of Physical Therapy, Texas Woman's University, Houston, Texas
School of Physical Therapy, Texas Woman's University, Houston, Texas
Correspondence and reprint requests to Melissa M. Merritt, PT, PhD(c), CHT, OCS, St. Joseph Rehabilitation Center, 3201 E. University Drive, Suite 280, Bryan, TX 77802
This research project was funded by the Evelyn Mackin Grant for Research in Hand Therapy through the American Society of Hand Therapy.
ABSTRACT