Finkelstein's test


Finkelstein's test is a test used to diagnose de Quervain's tenosynovitis in people who have wrist pain.
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, 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 in the abductor pollicis longus and extensor pollicis brevis tendons of the wrist. These two tendons belong to the first Extensor [tendon compartments of the wrist|dorsal compartment].
Finkelstein's test was described by Harry Finkelstein, an American surgeon, 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, 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.