{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:49:57Z","timestamp":1740167397317,"version":"3.37.3"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Ulnarly sided wrist pain is a common and challenging symptom. Arthroscopy has become a safe and effective tool for the correct diagnosis and treatment, proving to be better than all other clinical and imaging diagnostic methods. Some tests have been described for the diagnosis of triangular fibrocartilage (TFC) lesions, such as the trampoline test for peripheral lesions and the hook, ghost, and suction tests for foveal detachments. In tears at the disc level, when they affect all layers of the TFC (complete lesion) at the same point, testing with the probe will usually suffice for the diagnosis. However, in some apparently partial lesions, the probe cannot pass through all layers because the proximal and distal sites of the lesion are not aligned. There has been no arthroscopic test described for such cases.<\/jats:p><jats:p>\n          Case Description\u2003We describe a simple and practical test that we have called the \u201cbubble test\u201d in a typical case to diagnose TFC central injuries, aiming to discriminate partial from complete lesions, which are eventually hard to differentiate through direct vision and arthroscopic probing, leading to a direct influence onto the treatment. The bubble test is performed with external compression of the distal radioulnar joint (DRUJ) aspect, with the thumb on the back of the DRUJ and the index and middle fingers onto the volar aspect. The abrupt compression of this region causes the passage of air mixed with synovial fluid from the DRUJ to the radiocarpal joint, generating bubble formation.<\/jats:p><jats:p>\n          Clinical Relevance\u2003The bubble test should correlate to physical examination and imaging (magnetic resonance imaging [MRI]) findings and is particularly useful in central and degenerative (Type II) TFC lesions in patients complaining of chronic pain on the ulnar region of the wrist, with no history of trauma and with inconclusive MRI findings. Once the diagnosis is confirmed, arthroscopic treatment consists of wide debridement of the lesion with resection of the injured tissue and the local inflammatory reaction. Thus, it is essential for the correct treatment to define the exact location of the lesion and to know whether the disc injury is complete.<\/jats:p>","DOI":"10.1055\/s-0043-1769791","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T23:19:25Z","timestamp":1686611965000},"page":"137-141","source":"Crossref","is-referenced-by-count":0,"title":["The \u201cBubble Test\u201d in the Arthroscopic Diagnosis of Triangular Fibrocartilage Central Lesion: Description and Relevance to Treatment"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8120-136X","authenticated-orcid":false,"given":"Ricardo Kaempf de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Santa Casa de Miseric\u00f3rdia de Porto Alegre, Porto Alegre, Brazil"},{"name":"Department of Hand Surgeon, Santa Casa de Miseric\u00f3rdia de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7521-3823","authenticated-orcid":false,"given":"Jo\u00e3o Pedro Farina","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Santa Casa de Miseric\u00f3rdia de Porto Alegre, Porto Alegre, Brazil"},{"name":"Department of Hand Surgeon, Santa Casa de Miseric\u00f3rdia de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-265X","authenticated-orcid":false,"given":"M\u00e1rcio","family":"Aita","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Faculdade de Medicina do ABC, Santo Andr\u00e9, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1535-0586","authenticated-orcid":false,"given":"Ezequiel","family":"Zaidenberg","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6448-1294","authenticated-orcid":false,"given":"Pedro J.","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Hospital Universit\u00e1rio Madrid Montepr\u00edncipe, Universidad CEU San Pablo, Boadilla del Monte, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0266-7681(96)80135-5","article-title":"Functional anatomy of the triangular fibrocartilage complex","volume":"21","author":"T Nakamura","year":"1996","journal-title":"J Hand Surg [Br]"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.N.00053","article-title":"Triangular fibrocartilage complex: an anatomic review","volume":"3","author":"T S Pidgeon","year":"2015","journal-title":"JBJS Rev"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0363-5023(81)80170-0","article-title":"The triangular fibrocartilage complex of the wrist\u2013anatomy and function","volume":"6","author":"A K Palmer","year":"1981","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s00402-015-2153-6","article-title":"Update TFCC: histology and pathology, classification, examination and diagnostics","volume":"135","author":"M C Kirchberger","year":"2015","journal-title":"Arch Orthop Trauma Surg"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.hcl.2017.07.010","article-title":"Chronologic and geographic trends of triangular fibrocartilage complex repair","volume":"33","author":"T Saito","year":"2017","journal-title":"Hand Clin"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.jhsa.2016.01.005","article-title":"The \u201cFour-Leaf Clover\u201d Treatment Algorithm: a practical approach to manage disorders of the distal radioulnar joint","volume":"41","author":"S Kakar","year":"2016","journal-title":"J Hand Surg Am"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S0940-9602(00)80106-5","article-title":"Histological anatomy of the triangular fibrocartilage complex of the human wrist","volume":"182","author":"T Nakamura","year":"2000","journal-title":"Ann Anat"},{"issue":"09","key":"ref8","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s00256-009-0842-3","article-title":"Ulnar-sided wrist pain. 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