Diagnostic Dilemma: Testing to Differentiate UCL Sprains From Flexor-Pronator Elbow Strains in the Overhead Athlete.
Kevin E Wilk, Christopher A Arrigo, Alison Gordin, Ricardo Colberg, Jeffrey Dugas
PMID 42553792WHAT IT FOUND
A clinical commentary from a sports medicine center describing how to physically examine an overhead athlete's elbow to tell a UCL sprain apart from a flexor-pronator strain.
No study was conducted; it is expert opinion on examination technique.
What this paper is
This is a clinical commentary describing a differential-diagnosis examination process for UCL sprains versus flexor-pronator strains in overhead athletes. It reports no study, no participants, no intervention, and no outcome data. It is a single-center expert opinion on examination technique, not a research report.
What it does not show
No study was conducted; this is a single-center expert opinion with no participants, no reliability or validity data for any of the described tests. The authors themselves state that further research is needed to determine the validity of the Thinker test. The prone valgus stress test is presented as a modification of standard valgus testing, but no comparison data against the seated or supine version are provided. All recommendations reflect one sports medicine center's clinical preference, not a tested protocol.
The easy way to misread this
Do not treat the Thinker test or the prone valgus stress test as validated diagnostic tools. The authors explicitly state that further research is needed to determine the validity of the Thinker test, and no sensitivity, specificity, or inter-rater reliability data are provided for any of the described maneuvers. This is a description of one center's clinical preference, not evidence that these tests outperform standard valgus stress testing.