The tine test is a multiple-puncture

tuberculin Tuberculin, also known as purified protein derivative, is a combination of proteins that are used in the diagnosis of tuberculosis. This use is referred to as the tuberculin skin test and is recommended only for those at high risk. Reliable admin ...

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

test used to aid in the

medical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. The information re ...

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...

(TB). The tine test is similar to the

Heaf test The Heaf test, a diagnostic skin test, was long performed to determine whether or not children had been exposed to tuberculosis infection. The test was named after F. R. G. Heaf. Also known as the Sterneedle test, it was administered by a Heaf ...

, although the

Mantoux test The Mantoux test or Mendel–Mantoux test (also known as the Mantoux screening test, tuberculin sensitivity test, Pirquet test, or PPD test for purified protein derivative) is a tool for screening for tuberculosis (TB) and for tuberculosis diagn ...

is usually used instead. There are multiple forms of the tine tests which usually fall into two categories: the old tine test (OT) and the purified protein derivative (PPD) tine test. Common brand names of the test include Aplisol, Aplitest, Tuberculin PPD TINE TEST, and Tubersol.

Procedure

This test uses a small "button" that has four to six short needles coated with TB

antigen In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune response. ...

s (

), either an old tuberculin or a PPD-tuberculin. The needles are pressed into the skin (usually on the inner side of the forearm), forcing the antigens into the skin. The test is then read 48 to 72 hours later by measuring the size of the largest

papule A papule is a small, well-defined bump in the skin. It may have a rounded, pointed or flat top, and may have a dip. It can appear with a stalk, be thread-like or look warty. It can be soft or firm and its surface may be rough or smooth. Some h ...

induration A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this sy ...

. Indications are usually classified as positive, negative, or doubtful. Because it is not possible to control precisely the amount of tuberculin used in the tine test, a positive test should be verified using the

PPD

Tuberculin Tuberculin, also known as purified protein derivative, is a combination of proteins that are used in the diagnosis of tuberculosis. This use is referred to as the tuberculin skin test and is recommended only for those at high risk. Reliable admin ...

is a

glycerol Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...

extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a precipitate of non-species-specific molecules obtained from filtrates of sterilized, concentrated cultures. It was first described by

Robert Koch Heinrich Hermann Robert Koch ( , ; 11 December 1843 – 27 May 1910) was a German physician and microbiologist. As the discoverer of the specific causative agents of deadly infectious diseases including tuberculosis, cholera (though the Vibrio ...

in 1890 and then Giovanni Petragnani.A batch of PPD created in 1939 serves as the US and international standard, called PPD-S. PPD-S concentration is not standardized for multiple-puncture techniques, and should be designed for the specific multiple-puncture system.

Comparison to Mantoux test

The

American Thoracic Society The American Thoracic Society (ATS) is a nonprofit organization focused on improving care for pulmonary diseases, critical illnesses and sleep-related breathing disorders. It was established in 1905 as the American Sanatorium Association, and ch ...

Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...

(CDC) do not recommend the tine test, since the amount of tuberculin that enters the skin cannot be measured. For this reason, the tine test is often considered to be less reliable. Contrary to this, however, studies have shown that the tine test can give results that correlate well to the Mantoux test. If a minor reaction is considered doubtful, the OT test is less accurate and may fail to detect TB, producing a false negative. If all doubtful indications are instead classified as positive, there is no significant difference between the OT test, the PPD tine test, or the Mantoux test. Furthermore, the tine test is faster and easier to administer than the Mantoux test and has been recommended for screening children.

References

{{DEFAULTSORT:Tine Test Immunologic tests Skin tests Tuberculosis

Procedure

PPD

Comparison to Mantoux test

See also

References