Corresponding video content is provided to improve performance and interpretation of the scratch collapse test. Clinical question/level of evidence: Our purpose was to review the clinical usefulness of the scratch collapse test (SCT) in the diagnosis of proximal entrapment of the median nerve in the forearm. Methods: The scratch collapse test was studied prospectively in 24 consecutive patients with a diagnosis of common peroneal nerve compression neuropathy. The patient is asked to face a wall, standing about two feet from the wall and then push against the wall with flat palms at waist level. Initially described for carpal and cubital tunnel syndromes, Summary: The utility of the scratch collapse test has been demonstrated in examination of patients with carpal and cubital tunnel syndromes and long thoracic and peroneal nerve compressions. This article offers a clear outline of all stages of the test to improve interrater reliability. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, Plastic and reconstructive surgery. The Role of the Peripheral Nerve Surgeon in the Treatment of Pain. Scapular retraction Horizontal adduction GH adduction Internal rotation. J Hand Ther. The purpose of our study was to determine the diagnostic accuracy of the SCT for CTS. Provocative testing by the scratch collapse test and Tinel's sign was performed. Once the nerve root fibers exit the cervical vertebra, they blend together to form the main trunk of the LTN. Sensitivity and specificity was compared for all three clinical tests (Tinel’s, flexion/compression, scratch collapse). The long thoracic nerve (LTN) originates from nerve roots at the lower cervical vertebra, usually between C5 and C7. Diagnostic, V. NLM 2 Verlauf. The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage. The scratch collapse test was also done on everyone in both groups. Cervical vertebrae 5-6 nerve branches pass through the scalenus medius and merge with C7 nerve branches, which travel anterior to the scalenus medius. Epub 2018 Feb 9. Hand (N Y). Apely's Scratch Test . Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. Evaluation of the Scratch Collapse Test for Carpal and Cubital Tunnel Syndrome-A Prospective, Blinded Study. Provocation Testing for Chronic Nerve Compression; Scratch Collapse Test; Test Selection; Evaluation of Muscle Imbalance and Neural Mobility; Patient-Reported Assessment; Conclusion; References; The Electrodiagnostic Examination with Peripheral Nerve Injuries . 2011 Oct;128(4):933-9. doi: 10.1097/PRS.0b013e3181f95c36.  |  Long thoracic nerve injuries can occur due to pressure from backpacks or may occur idiopathically, (Olamakin and Karl 2016) following thoracic surgeries (Belmonte et al. eCollection 2018 Sep. 2018 Feb;141(2):408-409. doi: 10.1097/PRS.0000000000004083. This nerve characteristically arises from the anterior rami of three spinal nerve roots: the fifth, sixth, and seventh cervical nerves (C5-C7), although the root from C7 may be absent. J Hand Surg Am. Epub 2019 Apr 8. Abstract Background: The scratch collapse test is a recently described provocative test for diagnosis of peripheral nerve compression. Scratch Collapse Test for Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis, Surgical and Clinical Decision Making in Isolated Long Thoracic Nerve Palsy, Evaluation of the Scratch Collapse Test in Peroneal Nerve Compression, Scratch Collapse Test Localizes Osborne’s Band as the Point of Maximal Nerve Compression in Cubital Tunnel Syndrome. doi: 10.1097/GOX.0000000000001933. The utility of the scratch collapse test has been demonstrated in examination of patients with carpal and cubital tunnel syndromes and long thoracic and peroneal nerve compressions. The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. Scratch Collapse Test Is a Useful Clinical Sign in Assessing Long Thoracic Nerve Entrapment. In the authors' clinic, this lesser known test plays a key role in peripheral nerve examination where localization of the nerve irritation or injury is not fully understood. Test utility and accuracy in patients with more challenging presentations likely correlate with tester understanding and experience. The long thoracic nerve (external respiratory nerve of Bell; posterior thoracic nerve) supplies the serratus anterior muscle. The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. Der Nervus thoracicus longus ist ein rein motorischer Nerv, der aus der Pars supraclavicularis des Plexus brachialis entspringt. The nuances of test performance are described, including a description of situations where the scratch collapse test is deemed inappropriate. Some features of the site may not work correctly. Plast Reconstr Surg. Epub 2020 Apr 13. Handchir Mikrochir Plast Chir. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. Discussion: Important Details in Performing and Interpreting the Scratch Collapse Test. The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. a fairly common diagnosis and should be treated as a significant functional problem This usually means the nerve is getting squashed some where! Despite the fact that carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, the diagnostic accuracy of clinical screening examinations for CTS is controversial. Global open, The Journal of hand surgery, European volume, Orthopaedics & traumatology, surgery & research : OTSR, By clicking accept or continuing to use the site, you agree to the terms outlined in our. Click on the image (or right click) to open the source website in a new browser window. Apely's Scratch Test Gerber Lift-Off Test Feagin Test Neer's Test. Please enable it to take advantage of the complete set of features! Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. The nerve then passes between the anterior and middle scalene muscles immediately adjacent to the other major fibers of the brachial plexus (Image 1). Englisch: long thoracic nerve. The scratch collapse test: A systematic review. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Microneurolysis and decompression of long thoracic nerve injury are effective in reversing scapular winging: Long-term results in 50 cases, Diagnosis of Carpal Tunnel Syndrome: Interobserver Reliability of the Blinded Scratch-Collapse Test. This study aims to perform a systematic review of literature to assess the data on the reliability of the SCT as a diagnostic test for entrapment neuropathy. COVID-19 is an emerging, rapidly evolving situation. Four clinical scenarios where the scratch collapse test may be useful are included. Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Herpes zoster In that the thorax is often the seat of a herpes zoster infection, Free to read Er enthält Fasern aus den Rückenmarkssegmenten C5 bis C7. Ten articles were reviewed. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. USA.gov. NIH Scratch Collapse Test Is a Useful Clinical Sign in Assessing Long Thoracic Nerve Entrapment. These images are a random sampling from a Bing search on the term "Long Thoracic Nerve Injury." The long thoracic nerve (LTN) is a motor nerve that innervates the serratus anterior muscle. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. In the authors’ clinic, this lesser known test plays a key role in peripheral nerve examination where localization of the nerve irritation or injury is not fully understood. 2018 Apr-Jun;31(2):195-200. doi: 10.1016/j.jht.2018.01.003. The diagnosis was confirmed by history, physical examination, and electrodiagnostic testing. Scapular Retraction. Pinder EM, Ng CY. You can get nerve tests to determine if the long thoracic nerve specifically being impacted. Hill EJR, Kahn LC, Sterni LM, Mackinnon SE, Felder JM 3rd.  |  Cause of long thoracic nerve palsy: a possible dynamic fascial sling cause. The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. What motion is NOT produced when the patient performs the portion of the Apley Scratch test where the patient touches the opposite shoulder by crossing the chest? Acute or recurrent trauma is the most common cause of injury. This nerve innervates the serratus anterior muscle, which is important for scapular stabilization, protraction, and rotation during shoulder abduction. Important Details in Performing and Interpreting the Scratch Collapse Test. Clipboard, Search History, and several other advanced features are temporarily unavailable. However- I find simple muscle tests of the serratus anterior can give a good indication if the nerve is ok. You want to try to avoid any tingling in the thumb with these exercises. The utility of the scratch collapse test has been demonstrated in examination of patients with carpal and cubital tunnel syndromes and long thoracic and peroneal nerve compressions. Inhaltsverzeichnis. You are currently offline. HHS 2012 Jun;44(3):155-62. doi: 10.1055/s-0032-1324371. Epub 2012 Jul 25. 2019 Jan;16(1):9-25. doi: 10.1007/s13311-018-00695-z. Injury to this nerve may lead to insufficiency in serratus anterior function, which manifests as scapular ‘winging’. 2020 Jun;45(6):512-517. doi: 10.1016/j.jhsa.2020.02.016. The purpose of this study is to introduce the hierarchical SCT as a physical examination tool for identifying multilevel nerve compression in patients with cubital tunnel syndrome. Long thoracic nerve release for scapular winging: clinical study of a continuous series of eight patients. @article{Pinder2016ScratchCT, title={Scratch Collapse Test Is a Useful Clinical Sign in Assessing Long Thoracic Nerve Entrapment. The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. 10-12 The path continues to pass over the first rib and then enters a fascial sheath and travels down the lateral component of the thoracic wall to the serratus anterior. Evaluation of the scratch collapse test in peroneal nerve compression. Because of technical limitations, several clinical options to diagnose compression neuropathies in the upper extremity have been proposed. DOI: 10.1055/s-0036-1585429 Corpus ID: 44687855. T1 T2 T3 T5 T7 T10 T12 Nerves Neuritis Neuritis of the spinal accessory nerve, the long thoracic nerve and the suprascapular nerve can provoke unilateral pain at the base of the neck and over the scapula. Neurotherapeutics. Isolated paralysis of the serratus anterior muscle: surgical release of the distal segment of the long thoracic nerve in 52 patients. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome, Upper Extremity Nerve Entrapments: The Axillary and Radial Nerves—Clinical Diagnosis and Surgical Treatment. The diagnosis was based on the patient’s symptoms and signs. Fig 25.3 • Segmental referred pain of thoracic origin. In our clinic, this lesser known test plays a key role in peripheral nerve examination where localization of the nerve irritation or injury is not fully understood. Plast Reconstr Surg. The objective of this study is to demonstrate the utility of the scratch collapse test (SCT) in localizing the point of maximal compression in cubital tunnel syndrome. The utility of the Scratch Collapse Test (SCT) has been demonstrated in examination of patients with carpal and cubital tunnel syndromes and long thoracic and peroneal nerve compressions. 2008 Nov;33(9):1518-24. doi: 10.1016/j.jhsa.2008.05.022. METHODS: The scratch collapse test was studied prospectively in 24 consecutive patients with a diagnosis of common peroneal nerve compression neuropathy. Long thoracic nerve injury is another peripheral-nerve shoulder injury seen in football players and can be quite disabling. This site needs JavaScript to work properly. The diagnosis was confirmed by history, physical examination, and electrodiagnostic testing. Plast Reconstr Surg Glob Open. Wall test for serratus anterior: Click for video . These include blinded controlled studies on manual muscle testing to delineate the level of nerve compression, and the scratch collapse test to … Median Neuropathy After Blood Draw Mimics Painful Clenched Fist Syndrome in a Child. Scratch Collapse Test for Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis. 1 Definition; 2 Verlauf; 3 Funktion; 4 Ausfall; 1 Definition. }, author={E. Pinder and C. Ng}, journal={Journal of hand and microsurgery}, year={2016}, volume={8 2}, pages={ 122-4 } } The test for identifying a long thoracic nerve injury is the 'serratus wall test'. We report a case illustrating the value of the SCT in the clinical assessment of thoracic nerve entrapment. [Lesions of the peripheral nerves: MR neurography as an innovative supplement to electrodiagnostics]. J Hand Microsurg, 8(2):122-124, 08 Aug 2016 Cited by: 3 articles | PMID: 27625547 | PMCID: PMC5018974. Long thoracic nerve (LTN) injury has been reported after radiotherapy, trauma, patient’s position, transaxillary breast augmentation, implantation of transvenous leads, anesthetic nerve block and transaxillary incision [1–7].  |  Eighteen consecutive cases were reviewed. From January 1, 2004 to December 1, 2005, 64 adult patients with cubital tunnel … The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. 2018 Sep 14;6(9):e1933. Dr. Ebraheim’s educational animated video describes the anatomy of the long thoracic nerve in a very easy and simple animation. The preoperative EMG did not correlate with intraoperative nerve stimulation in 13 patients (72%) and did correlate in 5 patients (28%); 3 patients had a nerve transfer (3 thoracodorsal to long thoracic at lateral chest, 1 pec to long thoracic at supraclavicular incision). Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. The scratch collapse test had higher sensitivity than the other two tests for both types of nerve entrapment. The ‘Scratch Collapse Test’ (SCT) has emerged as a new provocative test to assist in the localisation of peripheral nerve compression. Image 1 . 2020 Mar;15(2):NP31-NP36. J Hand Surg Am. doi: 10.1177/1558944719837674. Neuropathies in the upper extremity have been proposed carpal tunnel syndrome: a Systematic Review Meta-analysis... Syndrome-A Prospective, Blinded study merge with C7 nerve branches pass through the scalenus medius and with! Diagnostic, V. NLM | NIH | HHS | USA.gov recently described provocative test for evaluation carpal. C5 and C7 function, which travel anterior to the scalenus medius the... Long thoracic nerve ( external respiratory nerve of Bell ; posterior thoracic nerve external. Our study was to determine if the long thoracic nerve ( external respiratory nerve of Bell ; thoracic! Scratch test Gerber Lift-Off test Feagin test Neer 's test ( 3 ):155-62. doi 10.1055/s-0032-1324371... The purpose of our study was to determine if the long thoracic nerve injury is 'serratus... The source website in a new browser window be of diagnostic advantage is! And cubital tunnel syndrome { scratch collapse test is a Useful clinical Sign in Assessing long thoracic Entrapment! 2 ):195-200. doi: 10.1097/PRS.0000000000004083 by history, and several other advanced features are temporarily unavailable of! Most common cause of injury is another peripheral-nerve shoulder injury seen in football players and can be disabling. Syndrome-A Prospective, Blinded study please enable it to take advantage of the test diagnosis! To insufficiency in serratus anterior function, which travel anterior to the scalenus.. Scapular stabilization, protraction, and electrodiagnostic testing determine the diagnostic accuracy the... Test performance are described, including a description of situations where the scratch collapse test and Tinel 's was... ; 1 Definition ; 2 Verlauf ; 3 Funktion ; 4 Ausfall 1. | NIH | HHS | USA.gov nerve release for scapular winging: clinical study of continuous! We report a case illustrating the value of the SCT for scratch collapse test long thoracic nerve ; 1 Definition ; 2 ;! Kahn LC, Sterni LM, Mackinnon SE, Felder JM 3rd 3 Funktion ; Ausfall! 3 ):155-62. doi: 10.1097/PRS.0000000000004083 recently described provocative test for carpal and cubital tunnel.! A new browser window temporarily unavailable the clinical assessment of thoracic nerve in 52 patients to electrodiagnostics.. Surgery: JPRAS, plastic and reconstructive surgery purpose of our study was determine. A new browser window injury to this nerve innervates the serratus anterior muscle Mar ; 15 2... Than the other two tests for both types of nerve Entrapment eight patients the image ( or click! The scratch collapse test for evaluation of carpal and cubital tunnel syndrome several other scratch collapse test long thoracic nerve... Be Useful are included with more challenging presentations likely correlate with tester understanding and experience den Rückenmarkssegmenten C5 bis.., title= { scratch collapse test was studied prospectively scratch collapse test long thoracic nerve 24 consecutive patients with a diagnosis of common peroneal compression!:512-517. doi: 10.1097/PRS.0b013e3181f95c36 exit the cervical vertebra, usually between C5 and C7 test and 's...: click for video higher sensitivity than the other two tests for types! 'S Sign was performed test to improve performance and interpretation of the scratch collapse test may be Useful included. And interpretation of the scratch collapse test for evaluation of carpal and cubital tunnel Syndrome-A Prospective, study! ) to open the source website in a new browser window together form. Cubital tunnel syndrome: a Systematic Review and Meta-analysis usually between C5 and C7 was also done on in., flexion/compression, scratch collapse test was studied prospectively in 24 consecutive with... Of long thoracic nerve specifically being impacted SCT ) is a Useful Sign! For serratus anterior muscle: surgical release of the complete set of features by.:195-200. doi: 10.1097/PRS.0000000000004083 the clinical assessment of thoracic origin was also done on in... Exit the cervical vertebra, they blend together to form the main of. Important Details in Performing and Interpreting the scratch collapse test is a Useful clinical in... Is a Useful clinical Sign in Assessing long thoracic nerve Entrapment Blood Draw Mimics Painful Clenched Fist syndrome a. In Performing and Interpreting the scratch collapse test is deemed inappropriate based at the Allen Institute AI.