Watson's Scaphoid Shift Test

Video Description

Watson shift test (aka scaphoid shift test).

1. The examiner places volar pressure with their thumb on the distal pole of the scaphoid and simultaneously uses their index finger to stabilize the proximal pole dorsally.
2. The patient's wrist is taken from ulnar deviation (scaphoid extension) to radial deviation (scaphoid flexion).
3. In radial deviation, the examiner's thumb - which forces the proximal pole of the flexed scaphoid to the dorsal lip of the radius - is removed.
4. A positive test will reproduce a painful clunk which represents a subluxation of the scaphoid.

It is important to be aware that the Watson test may be positive in patients without an SL dissociation if they have generalized ligamentous laxity and that this test must be correlated with the patient's history, exam and radiographs. Easterling and Wolfe published their results of the scaphoid shift test in 100 patients with asymptomatic, uninjured wrists and found that the prevalence of a positive scaphoid shift test was 32%.Easterling KJ, Wolfe SW. Scaphoid shift in the uninjured wrist. J Hand Surg Am. 1994 Jul;19(4):604-6. Level of Evidence: Undefined.
PMID: 7963316 (Link to Abstract)