A prospective pilot study of two new clinical tests for the presence of the palmaris longus tendon.

INTRODUCTION: This prospective pilot study assessed the effectiveness of two new clinical tests (Szczecin 1 and Szczecin 2) by comparing them with the All-India Institute of Medical Sciences (AIIMS) and Schaeffer's tests for detecting the presence of the palmaris longus (PL) tendon, using ultrasonography as the reference method. METHODS: A total of 370 wrists were assessed in 210 patients (107 male, 103 female) aged 18-86 years (median age: 54 years; IQR: 43 to 67), with a median body mass index of 27 kg/m² (IQR: 24 to 30). Four clinical tests were used: the Schaeffer's, AIIMS, Szczecin 1 and Szczecin 2. Tendon visibility, the difficulty of distinguishing the PL from the flexor carpi radialis tendon, the number of attempts required for correct execution and the subjective ease of the test were analysed. The presence of the PL tendon was confirmed by ultrasonographic examination. RESULTS: The sensitivity for the right hand was: Schaeffer's, 71%; AIIMS, 63%; Szczecin 1, 87%; Szczecin 2, 89%. For the left hand it was: Schaeffer's. 72%; AIIMS, 65%; Szczecin 1, 88%; Szczecin 2; 91%. Palmaris longus tendon absence in one or both hands was found in 13% of patients (or in 16% of all assessed hands). CONCLUSIONS: The two new tests showed higher sensitivity than the reference tests and may be more useful in daily clinical practice. LEVEL OF EVIDENCE: III.