Watson test

Name of test

Watson test

What it tests

The Watson test assesses possible damage to the scapholunate ligament and resultant instability between the scaphoid and lunate bones of the wrist

How to do it

The patient presents the hand, palm side up (supinated). (Figure 1)

The examiner grasps the patients wrist, placing her thumb on the scaphoid tubercle and the remaining four fingers on the dorsum of the patient’s wrist. (Figure 2)

Dorsal pressure is then applied by the thumb on the scaphoid tubercle

The patient’s hand is placed in a position of maximal ulnar deviation (Figure 3)

Using the contralateral hand, the examiner than moves the patient’s hand passively, to a point of maximal radial deviation. (Figure 4)

The normal response

Moving the patient’s hand passively from maximal ulnar deviation to a point of maximal radial deviation with dorsal pressure applied by the thumb on the scaphoid tubercle should not elicit any findings.

A positive test is heralded by an objectively appreciated "clunk" and subjectively reported pain.

What it means if not normal

If the scapholunate ligament is not intact, the pressure and motion will allow the scaphoid to subluxate over the dorsal lip of the distal radius.

Comments

An objectively positive test can be trusted. A negative test does not perfectly exclude a problem. A subjective response with no objective finding is highly non-specific (medical equivalent of "who knows?")

Citations

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