A grind test is a physical examination technique used to assess joint pain and dysfunction. The specific procedure varies depending on the joint being examined. Let's explore common examples:
Grind Tests for Different Joints
1. Carpometacarpal (CMC) Joint Grind Test (Thumb)
This test is used to diagnose osteoarthritis in the thumb's CMC joint.
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Procedure: The examiner grasps the patient's metacarpal bone of the thumb, applying gentle axial force while moving it in a circular motion. A positive test produces a palpable or audible grinding sensation. (Physiopedia: Thumb CMC Grind Test, Physiotutors: Grind Test | CMC 1 Osteoarthritis)
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Interpretation: A positive grind test suggests CMC osteoarthritis. However, a negative test doesn't definitively rule it out. (Physiotutors: Grind Test | CMC 1 Osteoarthritis) The test's accuracy is moderate. (PubMed: Diagnostic value of clinical grind test for carpometacarpal)
2. Patellar Grind Test (Clarke's Sign)
This test helps assess patellofemoral pain, potentially indicating cartilage damage in the knee.
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Procedure: The patient lies with their knee extended. The examiner presses the patella downwards while passively flexing and extending the knee. A positive test elicits pain. (Cleveland Clinic: Patellar Grind Test/Clarke's Sign, Physiopedia: Patellar Grind Test)
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Interpretation: Pain during the test suggests patellofemoral joint disorder, potentially including chondromalacia patellae or patellofemoral osteoarthritis. The test's clinical value is weak due to limitations in study methodology. (Physiotutors: Clarke's Sign)
3. Subacromial Grind Test (Shoulder)
This test evaluates shoulder pain, potentially indicating subacromial impingement.
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Procedure: With the shoulder abducted, the examiner passively internally and externally rotates the arm. A positive test reveals palpable crepitus or grinding. (NCBI: The accuracy of “subacromial grind test”)
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Interpretation: A positive finding suggests subacromial pathology.
Note: These are just a few examples; grind tests can be adapted for other joints. Accurate interpretation requires a thorough understanding of anatomy and clinical assessment. A healthcare professional should perform and interpret these tests.
