Function can be tested by providing resistance to abduction up and away from the plane of the palm. The patient actively (or active assistive) flexes thumb maximally and wraps fingers over thumb, making a fist. In most cases Physiopedia articles are a secondary source and so should not be used as references. The Finkelstein test is used in the diagnosis of De Quervain's syndrome. Finkelstein maneuver is a helpful test to diagnose De Quervain's Tendonitis or first dorsal compartment tendonitis named after the Swiss surgeon Fritz de Quervain. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Investigation into the validity of tests are important to know whether our tests are reliable or not. In the first compartment, the tendons of the extensor pollicis brevis and abductor pollicis longus pass through to attach distally. This fact implies a tenovaginitis and tenosynovitis of the M. extensor pollicis brevis and M. abductor pollicis longus. The inflammation causes the compartment (a tunnel or a sheath) around the tendon to swell and enlarge, making thumb and wrist movement painful. Read more, © Physiopedia 2020 | Physiopedia is a registered charity in the UK, no. Sorry, your blog cannot share posts by email. https://www.physio-pedia.com/index.php?title=Finkelstein_Test&oldid=245529. The Finkelstein test is used in the diagnosis of De Quervain's syndrome. 1173185, Richard Day, John Fox; Neuro- musculoskeletal clinical tests; Churchill Livingstone Elsevier 2009- page 113 (Level of evidence = E), Javier González-Iglesias, Peter Huijbregts, César Fernández-de-las-Peñas, Joshua A. Cleland; Differential Diagnosis and Physical Therapy Management of a Patient With Radial Wrist Pain of 6 Months’ Duration: A Case Report; journal of orthopaedic sports physical therapy: volume 40,number 6, June 2010. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. This causes additional stress on the extensor tendons of the thumb. The muscles that cross the wrist are separated into compartments by the extensor retinaculum. One research shows that the Finkelstein test has a high reliability. posterior interosseous branch of the radial nerve, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Tumblr (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on Pinterest (Opens in new window), Click to email this to a friend (Opens in new window), Hand Exam: Motor 7/13 – Extensor Pollicis Brevis (EPB) and Abductor Pollicis Longus (APL), Hand Exam: Motor 9/13 – Extensor Digitorum Communis (EDC) | Sketchy Medicine, Hand Exam: Motor 1/13 – Flexor Pollicis Longus (FPL) | Sketchy Medicine, Hand Exam: Motor 8/13 – Extensor Pollicis Longus (EPL) | Sketchy Medicine. The combination of maximum finger flexion and wrist ulnar deviation elongates these tendons and produces pain in symptomatic individuals. Top Contributors - Aurelie Canas Perez, Venus Pagare, Rachael Lowe, Kim Jackson and Tracy Hall. This site uses Akismet to reduce spam. Studies that test the reliability of the Finkelstein test are very limited. [1][2]. To begin, the patient must sit comfortable and relaxed on the examination table. 2nd edition. Resistance to movement of APB Prolonged compression will lead to impaired 2 point discrimination on sensory testing. This is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. St. Louis, MO: Mosby Elsevier, 2010. The Abductor Pollicis Brevis (APB) muscle receives sole innervation from the median nerve. Embarrassing to have that typo considering I now do tons of hand exams every single day. That is usually the journal article where the information was first stated. The therapist then asks the patient to make a fist around a thumb and to perform a ulnar deviation. Finkelstein maneuver is a helpful test to diagnose De Quervain's Tendonitis or first dorsal compartment tendonitis named after the Swiss surgeon Fritz de Quervain. The median nerve supplies the abductor pollicis brevis (APB) muscle at the lateral border of the thenar eminence which abducts the thumb at right angles to the palm. Oh wow, you’re completely right! Learn how your comment data is processed. Post was not sent - check your email addresses! Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Abductor Pollicis Longus (APL) Insertion: base of the 1st metacarpal; Action: extension of the 1st metacarpal and helps with abduction; Innervation: posterior interosseous branch of the radial nerve; Extensor Pollicis Brevis (EPB) Insertion: base of the proximal phalanx of thumb; Action: combines with EPL to extend thumb IP joint The abductor pollicis brevis muscle is located in the hand between the wrist and the base of the thumb. This is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb. Javier González-Iglesias, Peter Huijbregts, César Fernández-de-las-Peñas, Joshua A. Cleland; Differential Diagnosis and Physical Therapy Management of a Patient With Radial Wrist Pain of 6 Months’ Duration: A Case Report; journal of orthopaedic; sports physical therapy: volume 40, number 6, June 2010. It is a thenar muscle, and therefore contributes to the bulk of the palm's thenar eminence. The therapist grasps the afflicted hand of the patient and rotates it in ulnar deviation. Finkelstein’s test is the classic provocative test for diagnosis of De Quervain’s disease. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. This fact implies a tenovaginitis and tenosynovitis of the M. extensor pollicis brevis and M. abductor pollicis longus. Thenar Muscles: Instruct the patient “Bring your thumb out to the side” 303. The abductor pollicis brevis is a flat, thin muscle located just under the skin. All of the information on this website is purely for educational purposes and has not been peer-reviewed. The test is positive if the patient complains of pain over the 1st extensor compartment of the wrist. All supplied by posterior interosseous branch of the radial nerve. I’ve fixed it now. Neumann, Donald. [4], Sign up to receive the latest Physiopedia news, The content on or accessible through Physiopedia is for informational purposes only. Finkelstein hypothesized that the entry of the muscle bellies of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons into the first extensor compartment was responsible for the findings observed in his now eponymous test. Use these images to learn, but if you want to use them on your own website please credit me! (level of evidence = C), How to Perform a Finkelstein's Test of the Hand (level of evidence = E). Next, examine the patients hand in the air, while the other hand rests just beside the body. According to Neumann, the extensor pollicis brevis attaches distally to the dorsal side of the proximal phalanx and extensor mechanism of the thumb, while the abductor pollicis longus attaches distally to the radial-dorsal side of the 1st metacarpal. The part where it says hypothenar muscles , should actually be thenar muscles. Wasting of the interossei, obvious as prominent guttering of the back of the hand and of the web space between thumb and index and softening and flattening of the hypothenar eminence, with sparing of the APB is diagnostic of an ulnar … (level of evidence = C). A modified version of the test is that the patient must sit comfortable and relaxed on the examination table. It originates from the flexor retinaculum … The 13 muscle groups you need to test in the hand exam: Pingback: Hand Exam: Motor 9/13 – Extensor Digitorum Communis (EDC) | Sketchy Medicine, Pingback: Hand Exam: Motor 1/13 – Flexor Pollicis Longus (FPL) | Sketchy Medicine, Pingback: Hand Exam: Motor 8/13 – Extensor Pollicis Longus (EPL) | Sketchy Medicine. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. The patient then ulnarly deviates his/her wrist to stretch the muscles of the 1st extensor compartment. He pulls the patient’s thumb across the palm of his/ her hand. The patient must hold his afflicted hand in the air, while the other hand should be resting against his/ her body.

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