LAUSR

INTRODUCTION: Telehealth evaluations have become routinely incorporated into orthopaedic surgical practice due to the COVID- 19 pandemic. These limit the traditional physical exam, which is critical in evaluating orthopedic patients. Therefore, it is imperative to adapt to a "virtual" physical exam, which has been previously described for the lower extremity. This study aims to assess the feasibility of a virtual exam for the upper extremity and evaluate the necessary infrastructure requirements. METHOD(S): A list of the most common physical exam maneuvers and their specificities and sensitivities for shoulder, elbow, and hand and wrist function was aggregated from a systematic review. A simulation of the patient-physician encounter during a virtual upper extremity exam was performed using the instructions of the virtual tests. Photos of each physical exam maneuver were documented and assessed for feasibility. RESULT(S): Many of the special tests have large ranges for specificity and sensitivity. Out of the 11 tests for shoulder function, 5 for elbow function, and 5 for hand and wrist function evaluated in this study, all tests were feasibly replicated by the patient alone in a virtual setting with minimal common household items. CONCLUSION(S): Our assessment shows that a virtual upper extremity exam remains a feasible option. The specificity and sensitivity ranges of physical exam maneuvers performed in the clinic already vary greatly. Thus, translating these maneuvers to a virtual format will not hinder providers' ability to use the exam findings to guide further workup or advanced imaging for diagnosis and subsequent treatment.