Wrist - Special Test Flashcards
(13 cards)
Finkelstein’s Test
purpose: De Quervain’s tenosynovitis (APL & EPB)
perform: Patient seated; make a fist with thumb inside fingers. Examiner ulnarly deviates the wrist.
positive: Pain over radial styloid = positive
Bunnell-Littler Test
purpose: Differentiate between intrinsic muscle tightness vs. capsule restriction at PIP joint
perform: Patient seated; MCP held in extension, examiner passively flexes PIP. Then MCP is flexed and PIP flexed again.
positive: Increased flexion with MCP flexed = intrinsic tightness; no change = capsule tightness
Tight Retinacular Ligament Test
purpose: Identify tightness around PIP joint
perform: PIP held in neutral, DIP flexed. Then PIP flexed and DIP flexed again.
positive: Increased DIP flexion with PIP flexed = tight retinacular ligament; no change = joint capsule
Ligament Instability Tests
purpose: Collateral ligament integrity of fingers
perform: Patient seated; apply varus/valgus stress to PIP and DIP joints in extension and slight flexion.
positive: Laxity or pain = ligament sprain - results are compared for laxity with those of the uninvolved hand,
which is tested first
Froment’s Sign
purpose: Ulnar nerve dysfunction (adductor pollicis weakness)
perform: Patient holds paper between thumb and index finger. Examiner pulls paper away.
positive: IP flexion of thumb = positive (compensatory FPL activation)
Wartenberg’s Sign
purpose: Ulnar nerve palsy (neuropathy)
perform: Patient seated; instructed to adduct fingers. Inability to adduct 5th digit indicates interossei weakness.
positive: Inability to adduct pinky = positive
Hoffman’s Sign
purpose: Upper motor neuron lesion
perform: Flick distal phalanx of middle finger downward.
positive: Thumb and index finger flexion = positive UMN sign
Thumb Grind Test
purpose: First CMC OA
perform: Patient seated; examiner applies axial compression and rotation to thumb metacarpal into trapezium.
positive: Pain or crepitus = CMC OA
Murphy’s Sign
purpose: Lunate dislocation
perform: Patient makes a fist.
positive: 3rd metacarpal head remains level with 2nd and 4th = lunate dislocation
Tinel’s Sign (Wrist)
purpose: Median nerve compression (Carpal Tunnel Syndrome)
perform: Examiner taps over volar carpal tunnel.
positive: Tingling in thumb, index, middle fingers = positive
Phalen’s Test
purpose: Carpal Tunnel Syndrome of median nerve
perform: Patient seated; maximally flexes wrists and holds dorsum-to-dorsum for 60 sec.
positive: Tingling in median nerve distribution = positive
Two-Point Discrimination
purpose: Assess sensory integrity
perform: Patient seated; use discriminator tool or calipers on fingertip. Record minimum distance perceived as two points.
positive: <6 mm is normal; >6 mm may indicate sensory loss
Allen’s Test
purpose: Radial and ulnar artery patency - identify vascular compromise
perform: Patient opens and closes fist, examiner compresses both arteries, then releases one.
positive: Delayed blood return = insufficient arterial supply
