Adıgüzel Şahin Zennure, Üzel Mehmet, Güler Kahraman Yıldırım Fatma, Ercan Tanyeli Mahmut, Ertaş Ahmet, Palamar Deniz, Özekli Mısırlıoğlu Tuğçe, Akgün Kenan, Dirican Ahmet
Department of Anatomy, İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, İstanbul, Türkiye.
Department of Physical Therapy and Rehabilitation, İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, İstanbul, Türkiye.
Turk J Phys Med Rehabil. 2024 Oct 31;70(4):525-531. doi: 10.5606/tftrd.2024.13746. eCollection 2024 Dec.
This study aimed to evaluate the accuracy of four clinical tests confirmed by ultrasonography (USG) and to evaluate the role of age, sex, handedness, subcutaneous tissue thickness (STT), tendon thickness (TT), and STT/TT in determining the absence of the palmaris longus muscle.
In this descriptive study, 282 wrists of 141 healthy individuals (71 females, 70 males; mean age: 29±9.6 years; range, 21 to 55 years) were included between September 2021 and November 2022. The palmaris longus muscle tendon was identified by Schaeffer's test, Mishra's test I, Thompson's test, and Pushpakumar's test and then evaluated with USG. Before the tests, age, sex, and dominant hand information of the individuals were obtained. The STT and TT were measured with USG.
Sensitivity values by side were as follows (right/left respectively): Schaeffer's 92%/73%, Mishra's I 91%/93%, Thompson's 84%/87%, and Pushpakumar's 86%/91%. Specificity values by side were as follows (right/left respectively): Schaeffer's 87%/95%, Mishra's I 78%/82%, Thompson's 78%/79%, and Pushpakumar's 84%/82%. Sensitivity values by sex were as follows (female/male respectively): Schaeffer's 81%/96%, Mishra's I 92%/94%, Thompson's 85%/90%, and Pushpakumar's 91%/92%. Specificity values by sex were as follows (female/male respectively): Schaeffer's 68%/90%, Mishra's I 72%/90%, Thompson's 72%/85%, and Pushpakumar's 78%/85%. The intraclass correlation coefficient between clinical tests and USG was 0.94 for the left side and 0.95 for the right side.
Mishra's test I and Pushpakumar's test can be used in females, while Schaeffer's test and Mishra's test I can be used in males as a mutually supportive clinical test. Furthermore, while there may be false negative and false positive test results due to muscle variations, it should be noted that STT/TT is also effective, particularly on the right side.
本研究旨在评估经超声检查（USG）证实的四项临床检查的准确性，并评估年龄、性别、利手、皮下组织厚度（STT）、肌腱厚度（TT）以及STT/TT在确定掌长肌缺失方面的作用。
在这项描述性研究中，纳入了2021年9月至2022年11月期间141名健康个体（71名女性，70名男性；平均年龄：29±9.6岁；范围21至55岁）的282只手腕。通过谢弗试验、米什拉试验I、汤普森试验和普什帕库马尔试验识别掌长肌腱，然后用超声检查进行评估。在检查前，获取个体的年龄、性别和优势手信息。用超声检查测量STT和TT。
按侧别划分的敏感度值如下（右侧/左侧分别为）：谢弗试验92%/73%，米什拉试验I 91%/93%，汤普森试验84%/87%，普什帕库马尔试验86%/91%。按侧别划分的特异度值如下（右侧/左侧分别为）：谢弗试验87%/95%，米什拉试验I 78%/82%，汤普森试验78%/79%，普什帕库马尔试验84%/82%。按性别划分的敏感度值如下（女性/男性分别为）：谢弗试验81%/96%，米什拉试验I 92%/94%，汤普森试验85%/90%，普什帕库马尔试验91%/92%。按性别划分的特异度值如下（女性/男性分别为）：谢弗试验68%/90%，米什拉试验I 72%/90%，汤普森试验72%/85%，普什帕库马尔试验78%/85%。临床检查与超声检查之间的组内相关系数左侧为0.94，右侧为0.95。
米什拉试验I和普什帕库马尔试验可用于女性，而谢弗试验和米什拉试验I可用于男性作为相互支持的临床检查。此外，虽然由于肌肉变异可能会出现假阴性和假阳性检查结果，但应注意STT/TT也有效果，特别是在右侧。
