Skip to main content

Advertisement

SpringerLink
Log in

Do rheumatologists know how to squeeze? Evaluations of Gaenslen´s maneuver

  • Short Communication - Validation Studies
  • Published:
Rheumatology International Aims and scope Submit manuscript

An Education to this article was published on 24 March 2016

Abstract

The Gaenslen´s compression maneuver is the application of pressure on the metacarpophalangeal joints in order to evoke pain on a patient who has active synovitis. The results from the use of the maneuver are seen as controversial due to the lack of information describing the technique required for this procedure. The present study will aim to clarify uncertainty in regard to the form, pressure, and time required to apply the maneuver by rheumatologist. Rheumatologist were observed and monitored while performing the Gaenslen compression maneuver on a prosthetic, biomedical device. The device was shaped to mimic a human hand and equipped with a sensor to monitor the force and time of which the pressure was applied. One hundred and eight (62 %) participants gave a valid recording. From these, 121 (87.7 %) were made by certified rheumatologists. The most predominant method (104 physicians/75.4 %) of applying the maneuver was by using the right hand with superior approach. The median strength calculated in grams resulted in 299 gr (IQR 145) (range 150–741 gr). The median time expressed in milliseconds was of 956.6 ms (IQR 824.6) . This is the first study to assess a clinical maneuver in a qualitative and quantitative manner. The results from this study, more specifically the low number of usable recordings, and the wide range of force exerted in the squeeze test may explain the differences in sensitivity and specificity in clinical studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Wiesinger T, Smolen JS, Aletaha D, Stamm T (2013) Compression test (Gaenslen’s squeeze test) positivity, joint tenderness, and disease activity in patients with rheumatoid arthritis. Arthr Care Res 65(4):653–657. doi:10.1002/acr.21863

    Article  Google Scholar 

  2. Recht L, Lithman T, Rasmussen JO, Mathiesen FK (1988) A test to detect hand dysfunction. The Pract 232(1458):1236–1239

    CAS  Google Scholar 

  3. Eberhardt K, Recht L, Wollheim F, Lithman T, Pettersson H, Schersten B (1988) Detection of suspected inflammatory joint disease with a new simple self-administered hand test. Br J Rheumatol 27(6):457–461

    Article  CAS  PubMed  Google Scholar 

  4. Rigby AS, Wood PH (1990) A review of assignment criteria for rheumatoid arthritis. Scand J Rheumatol 19(1):27–41

    Article  CAS  PubMed  Google Scholar 

  5. Rigby AS, Wood PH (1991) The lateral metacarpophalangeal/metatarsophalangeal squeeze: an alternative assignment criterion for rheumatoid arthritis. Scand J Rheumatol 20(2):115–120

    Article  CAS  PubMed  Google Scholar 

  6. Visser H, le Cessie S, Vos K, Breedveld FC, Hazes JM (2002) How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthr Rheum 46(2):357–365

    Article  Google Scholar 

  7. Emery P, Breedveld FC, Dougados M, Kalden JR, Schiff MH, Smolen JS (2002) Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis 61(4):290–297

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. van der Helm-van Mil AH, le Cessie S, van Dongen H, Breedveld FC, Toes RE, Huizinga TW (2007) A prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: how to guide individual treatment decisions. Arthr Rheum 56(2):433–440. doi:10.1002/art.22380

    Article  Google Scholar 

  9. Arana-Guajardo A, Perez-Barbosa L, Vega-Morales D, Riega-Torres J, Esquivel-Valerio J, Garza-Elizondo M (2014) Application of a prediction model for the progression of rheumatoid arthritis in patients with undifferentiated arthritis. Reumatol Clin 10(6):360–363. doi:10.1016/j.reuma.2014.01.007

    Article  PubMed  Google Scholar 

  10. de Jong PH, Weel AE, de Man YA, Huisman AM, Gerards AH, van Krugten MV, Luime JJ, Hazes JM (2012) Brief report: to squeeze or not to squeeze, that is the question! Optimizing the disease activity score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis. Arthr Rheum 64(10):3095–3101. doi:10.1002/art.34568

    Article  Google Scholar 

  11. van den Bosch WB, Mangnus L, Reijnierse M, Huizinga TWJ, van der Helm-van Mil AHM (2015) The diagnostic accuracy of the squeeze test to identify arthritis: a cross-sectional cohort study. Ann Rheum Dis. doi:10.1136/annrheumdis-2014-207202

    Google Scholar 

  12. Mapp PI (1995) Innervation of the synovium. Ann Rheum Dis 54(5):398–403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Woolf AD, Akesson K (2008) Primer: history and examination in the assessment of musculoskeletal problems. Nat Clin Pract Rheumatol 4(1):26–33. doi:10.1038/ncprheum0673

    Article  PubMed  Google Scholar 

  14. Krabben A, Stomp W, Huizinga TW, van der Heijde D, Bloem JL, Reijnierse M, van der Helm-van Mil AH (2015) Concordance between inflammation at physical examination and on MRI in patients with early arthritis. Ann Rheum Dis 74(3):506–512. doi:10.1136/annrheumdis-2013-204005

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Carlos A Vaquera and Daniel L Vázquez helped in the biomechanical device construction and developed the strength force software. Ana Arana and Kiber González supported in writing process. AbbVie Laboratories México is thanked for their support in the field work. This work was funded by Colegio Mexicano de Reumatología.

Author information

Authors and Affiliations

  1. Rheumatology Service, Internal Medicine Department, Hospital Universitario “Dr. José Eleuterio González” Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico

    David Vega-Morales, Jorge Antonio Esquivel-Valerio & Mario Alberto Garza-Elizondo

Authors
  1. David Vega-Morales
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Antonio Esquivel-Valerio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mario Alberto Garza-Elizondo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Vega-Morales.

Ethics declarations

Ethical standard

Approval by Comité de Ética y Subdirección de Investigación de la Facultad de Medicina y Hospital Universitario “Dr. José Eluterio González” de la Universidad Autónoma de Nuevo León.

Conflict of interests

We do not have anything that interferes with, or could reasonably be perceived as interfering with, the full and objective presentation, peer review, editorial decision making, or publication of research or non-research articles submitted.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vega-Morales, D., Esquivel-Valerio, J.A. & Garza-Elizondo, M.A. Do rheumatologists know how to squeeze? Evaluations of Gaenslen´s maneuver. Rheumatol Int 35, 2037–2040 (2015). https://doi.org/10.1007/s00296-015-3354-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-015-3354-6

Keywords

Search

Navigation