Execution:
- The patient stands in front of a mirror for the examiner to gauge their reaction
- The examiner places one hand on the patient’s upper thoracic spine with the palm towards their body
- The examiner performs 1-2 percussions with the fist of the other hand and of at least moderate strength
- The examiner moves down until the thoraco-lumbar junction and repeats the process
Positive outcome: Sharp pain experienced by the patient
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Langdon et al. (2010) | NA | 87.5 | 90 | 8.75 | 0.14 |
| Comment: The Closed-Fist Percussion Test can should be used in combination with the supine sign in case of a suspected thoracic compression fracture. | |||||
