The Reliability of the “Scratch Test”

Abstract

The "Scratch Test" uses a sharp scalpel to scrape areas of suspected tendinosis in the management of lateral and medial epicondylitis. As claimed in the literature, this tissue is friable and peels off, whereas normal tendon does not. The purpose of this study was to determine whether, or not, the "Scratch Test" is able to differentiate between tendinosis and more normal adjacent tendon. Nineteen specimens from patients treated for tendinosis about the elbow were examined histologically. Three groups of specimens were compared: (1) grossly abnormal tendon, (2) tendon that was scraped out using the "Scratch Test" and (3) tendon that remained behind following the "Scratch Test". There was no significant histological difference between visibly degenerated tendon (group 1) and that which was scraped out using the "Scratch Test" (group 2). There was, however, a significant histological difference between both these groups and the more normal tendon tissue that the "Scratch Test" left behind (group 3).