What do we know about the reliability and validity of physical examinationtests used to examine the upper extremity?

The literature regarding the reliability and validity of commonly used clin ical tests for disorders of the upper extremity was reviewed. Formal litera ture search, standard texts, and experts in the field of upper extremity we re consulted to locate relevant articles. Range of motion and strength test ing of the upper limb have been shown to be reliable, while various tests u sed for the diagnosis of conditions in the upper limb, such as carpal tunne l syndrome and rotator cuff tendinopathy, have been shown to have varying d egrees of validity. Overall, however, we determined that there is little ev idence regarding the reliability and validity of physical examination for t he upper extremity and specifically less information available regarding th e reliability of diagnostic physical examination tests and the validity of impairment measures used for the upper limb. Further studies in this area a re warranted in view of the impact of these findings on the treatment of pa tients. (J Hand Surg 1999;24A:185-193. Copyright (C) 1999 by the American S ociety for Surgery of the Hand.)