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Hierarchical Scratch Collapse Test

Hierarchical Scratch Collapse Test Version (1.130215.130113) The scratch collapse is a provocative test for nerve compression and is one of many examination techniques used in the diagnosis of nerve injuries. There are minute details in performing a scratch collapse that can help with the interpretation of the diagnosis. The use of ethyl chloride allows for a hierarchical scratch collapse that can reveal and discriminate additional sites of compression. This video describes a hierarchical test in a patient with mild cubital tunnel syndrome with a primary scratch collapse at the medial epicondyle. The use of ethyl chloride reveals a secondary site of the flexor carpi ulnaris followed by the antebrachial fascia (Guyon's canal), deep motor branch of ulnar nerve, arcade of Struthers, thoracic outlet and finally the parascapular muscles. Table of Contents 00:00 Introduction 00:20 Hierarchy Findings of Scratch Collapse 00:43 Patient Examination 01:40 Scratch Collapse Test Narration: Susan E. Mackinnon Videography: Andrew Yee