Written by Doug Wallace
Spoon Feed
The Ten Test is a quick, reliable, no-equipment sensory exam that performed as well as or better than traditional methods in assessing hand and finger injuries – with none of the cost.
Ten out of ten…Sensational!
Sensory evaluation of the hand is essential but often unstandardized in the ED. The commonly used two-point discrimination (2PD) test is easy to teach but suffers from poor reproducibility and requires special tools. Other more accurate tests, like the Semmes-Weinstein Monofilament (SWM) or Weinstein Enhanced Sensory Test (WEST), require specialized, fragile, and expensive equipment, limiting their ED utility.
The Ten Test (TT), in contrast, uses nothing but the examiner’s fingertip and the patient’s subjective comparison to a contralateral normal digit (see Figure 4 from the article). It was found to have high interrater reliability (ICC 0.91–0.95) and superior performance over 2PD in detecting early sensory loss and recovery after nerve repair.
While the TT lacks an objective output and cannot measure fine discrimination thresholds, its accessibility, speed, and ease of use led the authors to suggest it is well-suited for emergency medicine.
How will this change my practice?
This is practice changing for me. In cases of hand trauma where I’m assessing sensory function, I plan to use the Ten Test. It’s fast, requires no tools, and offers a reliable, reproducible test that specialists recognize. Unlike other methods, it actually requires no gear, just a little tactile confidence.
Source
The Ten Test and Sensory Evaluation of Hand and Finger Injuries in the Emergency Department. J Emerg Med. 2025 Apr;71:54-59. doi: 10.1016/j.jemermed.2024.10.008. Epub 2024 Nov 1. PMID: 39984322
