Carpal Supination Test
The "carpal supination test" is not a standardized clinical examination described in current medical literature or guidelines, and no established diagnostic test by this name exists for wrist assessment.
What You May Be Looking For
Based on the biomechanical principles of wrist function, you may be referring to one of these related concepts:
Dynamic Supination Stress Testing
- The Bilateral Ulnar Deviation Supination (BUDS) test is a radiologic examination that assesses dynamic scapholunate instability through resisted isometric contraction of the extensor carpi ulnaris muscle with full forearm supination 1
- This test exploits the known scaphoid pronation effect of the extensor carpi ulnaris muscle to reveal ligamentous injury 1
- The procedure involves bilateral comparative radiographic assessment during forced supination, with a positive test showing >2.6 mm difference in scapholunate joint gap between symptomatic and asymptomatic wrists 1
Imaging During Supination/Pronation
- CT imaging in maximal supination and pronation positions is the modality of choice for evaluating distal radioulnar joint stability 2
- The protocol includes imaging both wrists in maximal pronation, neutral position, and maximal supination to assess joint stability 2
- Ultrasound can demonstrate dynamic subluxation of the extensor carpi ulnaris tendon during forced supination 2
Biomechanical Context
- Radio-metacarpal rotation (RMR) represents passive rotational movement at the wrist that varies with grip strength and applied torque, averaging 42 degrees when the wrist is relaxed 3
- Following scapholunate interosseous ligament injury, there is significant increase in scaphoid pronation and lunate supination during wrist motion, requiring greater extensor carpi ulnaris force 4
Clinical Pitfall
If you are attempting to assess carpal instability or ligamentous injury, do not rely on a non-standardized "supination test"—instead, begin with standard radiographs in multiple views 5, followed by MRI or MR arthrography for suspected ligamentous pathology 2, 6, or CT in supination/pronation for distal radioulnar joint assessment 2.