Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Palpation of soft tissue

Place one finger just radially to the dorsal tubercle of the radius. Ask the subject to make a first and to squeeze and unsqueeze it. During this action tendinous tightening can be felt. These are the tendons of the extensor carpi
radialis longus and extensor carpi radialis brevis. When the subject continues these muscular contractions the tendons can be followed, approximately 2 cm more distally, until the point where they separate.

The most radial tendon (longus) is felt to insert at the radial aspect of the base of the second metacarpal bone and the more ulnar tendon (brevis) inserts at the radial aspect of the base of the third metacarpal bone.Place one finger just ulnar to the dorsal tubercle of the radius. Ask the subject to extend the thumb.

Feel for the extensor pollicis longus tendon, which is the ulnar border of the anatomical snuffbox. It can be palpated until its insertion onto the distal phalanx of the thumb: the tendon turns 45° around the dorsal tubercle of the radius, crosses over the extensor carpi radialis longus and brevis, and goes
towards the thumb.

Palpate the dorsal aspect of the wrist while the subject extends the fingers. Movement can be felt of the tendons of the extensor digitorum communis
and of the extensor indicis proprius. When one finger is extended at a time the different tendons can be palpated one by one. Place one finger just radially to the head of the ulna. Ask the subject to extend the little finger and feel for the extensor digiti minimi. This tendon overlies the distal radioulnar joint.

Place one finger at the inferior and ulnar border of the head of the ulna . Ask the subject to perform an ulnar deviation during extension. The strong and thick tendon of the extensor carpi ulnaris is felt. It can be followed to its insertion at the base of the fifth metacarpal bone.

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