Name: Piano Key Sign and Examination of DRUJ Instability
Uploaded: 2024-05-31T00:00:00.0000000
Duration: T00H02M48S
Description: Piano Key Sign and Examination of DRUJ Instability

Name: Piano Key Sign and Examination of DRUJ Instability

Description: Piano Key Sign and Examination of DRUJ Instability

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Duration: T00H02M48S

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Upload Date: 2024-05-31T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
Today I'm going to demonstrate how to see instability of distal radial ulnar joint. So and I will also demonstrate the piano key sign which is present on one of my patients. So we will start with examination of normal behavior first. So I have my resident here. So the position is that you keep the elbow flexed and so that you have got full control of the hand and the normal dialogue has got some mobility, because that is what it allows rotation.
So if I demonstrate for you first wrist slight, slight neutral and then holding the shaft ulna. And if you see this is already created, you will see that there is some movement at the edge. So you can translate the ulna shaft of both dorsally and slowly. But this is physiological movement. How do you differentiate whether it's physiological movement or pathological movement due to instability?
All you need to do is, instead of ulnar deviation, take the risk to a radial deviation. And if you try the same thing, I can't. I can barely move it. So you will see some movement because it's not. The joint has got some mobility, but the movement decreases. So that is this tells me that previous movement was physiological. And once I have corrected from ulnar deviation to radial deviation, I can barely see this movement and this is pretty normal for me.
Now I'm going to demonstrate the same thing in the patient and I will also demonstrate a piano key sign. Now, this is a gentleman who had injury around a year ago and has been troubled by painful rotation, especially pronation and supernation. So if I do the same thing, ulnar deviation, you can see it's already subflexed and you can see how much it's moving. There's a lot of movement at the DRUJ.
Even it's ulnar deviated. Even when I do radial deviation. Still, there is a lot of carscellations. This tells me that this is pathological movement. Now, to demonstrate the piano key test, it's very easy if to keep the hand through it. And if I press this like a piano, it will go down and it will pop up. So if you can see here, I'm pressing it down and it's popping up like a piano key.
So this is also a sign of DRUJ instability. So when I press it down, it goes down. When I lift it up, it goes up. So if you look it from this profile, so if you see, I can press it down. And as I leave it, it pops up. So this is piano key sign for instability of DRUJ.

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