Finkelstein's test is a test used to

diagnose Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems enginee ...

de Quervain's tenosynovitis in people who have

wrist pain file:Wrist pain.jpg, 300px, An illustration of wrist pain Wrist pain or open wrist is a type of syndrome that prevents the patient using their hand due to a painful wrist. The pain may be sharp, sometimes steadily increasing after trying to apply fo ...

. Classical descriptions of the Finkelstein's test are when the examiner grasps the thumb and ulnar deviates the hand sharply. If sharp pain occurs along the distal radius (top of forearm, close to wrist; see image), de Quervain's tenosynovitis is likely. Finkelstein's test is commonly confused with Eichhoff's test: the Eichhoff's test is typically described as the examiner grasping and ulnar deviating the hand when the person has their thumb held within their fist. If sharp pain occurs along the distal radius, Quervain's tenosynovitis is suspected. Eichhoff's test may produce false positive results, while a Finkelstein's test performed by a skilled practitioner is unlikely to produce a false positive.

Purpose

Finkelstein's test is one way to determine if there is

tenosynovitis Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon, typically leading to joint pain, swelling, and stiffness. Tenosynovitis can be either infectious or noninfectious. Common clinical manifest ...

in the

abductor pollicis longus In human anatomy, the abductor pollicis longus (APL) is one of the extrinsic muscles of the hand. Its major function is to abduct the thumb at the wrist. Its tendon forms the anterior border of the anatomical snuffbox. Structure The abductor p ...

and

extensor pollicis brevis In human anatomy, the extensor pollicis brevis is a skeletal muscle on the dorsal side of the forearm. It lies on the medial side of, and is closely connected with, the abductor pollicis longus. The extensor pollicis brevis (EPB) belongs to the ...

tendons of the wrist. These two tendons belong to the first dorsal compartment. * First dorsal compartment: abductor pollicis longus and extensor pollicis brevis. * Second dorsal compartment: extensor carpi radialis longus and

extensor carpi radialis brevis In human anatomy, extensor carpi radialis brevis is a muscle in the forearm that acts to extend and abduct the wrist. It is shorter and thicker than its namesake extensor carpi radialis longus which can be found above the proximal end of the exten ...

. * Third dorsal compartment:

extensor pollicis longus In human anatomy, the extensor pollicis longus muscle (EPL) is a skeletal muscle located dorsally on the forearm. It is much larger than the extensor pollicis brevis, the origin of which it partly covers and acts to stretch the thumb together w ...

. * Fourth dorsal compartment:

extensor digitorum The extensor digitorum muscle (also known as extensor digitorum communis) is a muscle of the posterior forearm present in humans and other animals. It extends the medial four digits of the hand. Extensor digitorum is innervated by the posterior int ...

and

extensor indicis In human anatomy, the extensor indicis roprius'' is a narrow, elongated skeletal muscle in the deep layer of the dorsal forearm, placed medial to, and parallel with, the extensor pollicis longus. Its tendon goes to the index finger, which it ex ...

. * Fifth dorsal compartment:

extensor digiti minimi The extensor digiti minimi (extensor digiti quinti proprius) is a slender muscle of the forearm, placed on the ulnar side of the extensor digitorum communis, with which it is generally connected. It arises from the common extensor tendon by a thi ...

. * Sixth dorsal compartment:

extensor carpi ulnaris In human anatomy, the extensor carpi ulnaris is a skeletal muscle located on the ulnar side of the forearm. The extensor carpi ulnaris acts to extend and adduct at the carpus/wrist from anatomical position. Being an extensor muscle, extensor carp ...

History

Finkelstein's test was described by

Harry Finkelstein Harry may refer to: TV shows * ''Harry'' (American TV series), a 1987 American comedy series starring Alan Arkin * ''Harry'' (British TV series), a 1993 BBC drama that ran for two seasons * ''Harry'' (talk show), a 2016 American daytime talk show ...

(1865–1939), an American

surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...

, in 1930. A similar test was previously described by Eichhoff, in which the thumb is placed in the palm of the hand and held with the fingers, and the hand is then ulnar deviated (see images), causing intense pain over the radial styloid which disappears if the thumb is released. This test produces more false positive results than the test described by Finkelstein.

Method

The examiner pulls the thumb of the patient in ulnar deviation and longitudinal traction. If there is an increased pain in the radial styloid process and along the length of the extensor pollicis brevis and abductor pollicis longus tendons, then the test is positive for de Quervain’s syndrome.

Special considerations/implications

Eichhoff's test is commonly mislabeled as being Finkelstein's test. This is significant because Eichhoff's test may create pain in other tissues to come back a false positive or may come back negative though de Quervain’s syndrome is still suspected, the patient can radially deviate against resistance to possibly reproduce pain. If performed correctly by the examiner, Finkelstein's test does not give false positives.

References

* Konin, Jeff G., Denise L. Wiksten, Jerome A. Isear, and Holly Brader. ''Special Tests for Orthopedic Examination''. 3rd ed. Thorofare, NJ: SLACK Incorporated. 2006. 113–114. Print. * Starkey, Chad, Sara D. Brown, and Jefferey L. Ryan. ''Orthopedic and Athletic Injury Evaluation Handbook''. Philadelphia: F.A. Davis. 2010. 524. Print. {{Orthopedic examination , state=autocollapse Musculoskeletal examination