MURPHY'S

SIGN

​• T​est positioning

The client may sit or stand.

The therapist stands in front of the subject.

​• Action

The client is instructed to make a fist.

The therapist notes the position of the third metacarpal.

​• Positive finding

If the client's third metacarpal is level with the second and fourth metacarpals, a dislocated lunate is indicated.

​• Special considerations & comments

With normal anatomical alignment, the position of the lunate makes the third metacarpal appear longer than the others when a fist is made.

Thus, altering the position of the lunate in an anterior or posterior direction will allow for the third metacarpal to slide more proximally.

Murphy's Sign for the wrist and hand is based on the work of Dr. James Murphy in diagnosing lunate dislocation, with contributions from Dr. James Cyriax in understanding wrist joint mechanics and pathology.