Wrist Orthopaedic Test: Finkelstein Test

Finkelstein's test is a clinical test used to diagnose De Quervain’s disease, which is a painful condition that affects the tendons in the wrist near the base of the thumb. De Quervain’s disease is caused by inflammation of the tendons that control the movement of the thumb.

Procedure:

1. Ask the patient to make a fist with their thumb inside their fingers.
2. Instruct the patient to bend their wrist towards the little finger.
3. Use your other hand to gently stabilize the patient's forearm.
4. Next, ask the patient to move their wrist towards the thumb side of their hand.
5. Apply a slight pressure on the patient’s thumb and move it towards the forearm.
6. Observe the patient for any pain or discomfort during the movement.
7. Repeat the test on the other hand for comparison, if necessary.

If the patient experiences pain or discomfort in the wrist near the base of the thumb during this maneuver, it is considered a positive Finkelstein’s test, which is indicative of De Quervain’s disease.

The sensitivity and specificity of the Finkelstein's test vary depending on the study, but some research suggests that it has a sensitivity of 84% and a specificity of 96% for the diagnosis of De Quervain's disease.

A positive Finkelstein's test is indicated by the presence of pain or discomfort in the wrist near the base of the thumb during the maneuver. A negative Finkelstein's test is indicated by the absence of pain or discomfort during the maneuver.

References:

1. Chen MJ, Lew HL. Comprehensive Review of De Quervain Tenosynovitis. World J Orthop. 2016 Jul 18;7(7):400-7. doi: 10.5312/wjo.v7.i7.400. PMID: 27478557; PMCID: PMC4952339.
2. Magee DJ. Orthopedic Physical Assessment. 6th ed. St. Louis, Mo: Saunders/Elsevier; 2014.
3. Yalcin N, Gurcay E, Cakir E, Karakaya J. Finkelstein's Test and Ultrasonographic Evaluation of De Quervain's Disease: Diagnostic Value of Cross-Sectional Area of the First Dorsal Compartment and Association with Clinical Outcomes. J Hand Surg Asian Pac Vol. 2019 Sep;24(3):283-289. doi: 10.1142/S2424835519500342. PMID: 31474167.
4. Kim DH, Kim TH, Lee JW, Kim HK, Kim US, Kang SW. The Diagnostic Value of Finkelstein's Test, Ultrasonography, and MRI for De Quervain's Disease. Clin Orthop Surg. 2013 Jun;5(2):123-8. doi: 10.4055/cios.2013.5.2.123. PMID: 23730304; PMCID: PMC3663173.