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Validity of Using the Scratch Collapse Test in the Lower Extremities.

John J Pisquiy¹, Jordan T Carter¹, Gilberto A Gonzalez¹

¹From the Department of Orthopaedic Surgery, Texas Tech University Health Science Center El Paso, Foster School of Medicine.

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|May 18, 2022

Summary

The scratch collapse test can effectively diagnose upper extremity neuropathies using the lower extremity as an alternative testing site. This provides a valuable option when upper limb testing is not feasible.

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Area of Science:

Neurology
Diagnostic Medicine
Orthopedics

Background:

The scratch collapse test is a diagnostic tool for peripheral neuropathies, typically performed on the elbow.
Upper extremity testing may be contraindicated in certain clinical scenarios.
Investigating alternative testing sites is crucial for comprehensive diagnostic capabilities.

Purpose of the Study:

To evaluate the sensitivity of the scratch collapse test when performed on the lower extremity for diagnosing upper extremity neuropathies.
To determine if the lower extremity can serve as a viable alternative site for the scratch collapse test.
To compare the diagnostic accuracy of the scratch collapse test on upper versus lower extremities.

Main Methods:

One hundred patients with confirmed carpal tunnel or cubital tunnel syndrome were prospectively enrolled.
The scratch collapse test was performed on the elbow as a control and then on the foot/ankle (eversion against inversion).
Sensitivity and confidence intervals were calculated for both testing sites.

Main Results:

89% of patients had a positive scratch collapse test on the upper extremity, while 84% were positive on the lower extremity.
For carpal tunnel syndrome, sensitivities were 88.2% (upper) and 82.35% (lower).
For cubital tunnel syndrome, sensitivities were 89.8% (upper) and 85.7% (lower).

Conclusions:

No statistically significant difference was found in the sensitivities between upper and lower extremity testing.
The lower extremity can serve as an alternative site for the scratch collapse test.
This finding offers a valuable alternative for diagnosing upper extremity neuropathies when elbow testing is not possible.