title: Side-to-side confrontational strength-testing for weakness of the intrinsic muscles of the hand.
abstract: A prospective study of 217 patients was performed to determine the sensitivity and specificity of standard manual testing and of a new method, termed confrontational testing, for detecting weakness of the intrinsic muscles of the hand. Electrodiagnostic testing was used to identify the presence of any neurological disorder and to provide a control for the manual testing methods. Standard manual testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 14 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 57 per cent. Confrontational testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 82 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 87 per cent. Standard manual testing of the muscles innervated by the median nerve revealed a sensitivity of 6 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 49 per cent. Confrontational testing of the muscles innervated by the median nerve revealed a sensitivity of 16 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 52 per cent.
authors.affiliation: Indiana University Medical Center, Indianapolis 46202-5111, USA.
authors.forename: R
authors.initials: R
authors.lastname: Buschbacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004568:Electrodiagnosis; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis*; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D010808:Physical Examination / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014459:Ulnar Nerve / Q000503:physiopathology