{"id":1138,"date":"2010-12-04T08:56:00","date_gmt":"2010-12-04T08:56:00","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/specific-tests-3\/"},"modified":"2024-02-01T11:17:33","modified_gmt":"2024-02-01T11:17:33","slug":"specific-tests-3","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-upper-extremities\/the-wrist-and-the-hand\/specific-tests-3\/","title":{"rendered":"Specific Tests"},"content":{"rendered":"<hr \/>\n<p><span style=\"color: #003366;\"><strong>Finkelstein Test<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">This test is conducted when <span style=\"color: #33cccc;\"><strong>De Quervain syndrome<\/strong><\/span> is suspected (<em>tenosynovitis of the abductor pollicis longus muscle and the extensor pollicis brevis muscle<\/em>).<\/span><\/p>\n<hr \/>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124036785?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Holding the wrist of the patient, carry out passive ulnar abduction, leaving the thumb free. The patient will indicate no pain or mild pain at the level of the radial styloid process <em><strong>[Figure 137]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1133\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-137.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-137.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-137-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 137<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Then, carry out passive abduction of the patient\u2019s wrist again, but this time ask the patient to hold the thumb inside the fist <em><strong>[Figure 138]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1134\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-138.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-138.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-138-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 138<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">The test is positive if the pain symptoms increase during the latter.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Test For Suspected Carpal Tunnel Syndrome<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">These tests are indicated when a patient complains about tingling and\/or pain and\/or loss of strength in the hand (<em>atrophy of the thenar<\/em>).<\/span><\/p>\n<hr \/>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124036796?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Tinel\u2019s Sign<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">The investigator taps with the middle finger or a reflex hammer at the level of the carpal ligament (<em>palmar side<\/em>) on the middle of the patient\u2019s wrist. <\/span><\/li>\n<li><span style=\"color: #003366;\">The wrist should be in slight dorsiflexion during this procedure. <\/span><\/li>\n<li><span style=\"color: #003366;\">A tingling feeling in the area of the median nerve is typical when one taps on, or just proximally to, the affected location, along the pathway of the nerve <em><strong>[Figure 139]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">The symptom is said to be positive if the same pain and\/or tingling as previously reported by the patient can be induced (<em>median nerve distribution<\/em>).<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1135\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-139.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-139.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-139-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 139<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Phalen Manoeuvre<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient to hold the backs of both hands against each other (<em>maximum palmar flexion<\/em>) for at least one minute <em><strong>[Figure 140]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1136\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-140.jpg\" alt=\"\" width=\"400\" height=\"293\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-140.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-140-300x220.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 140<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient to hold the palms of both hands against each other (<em>maximum dorsal flexion<\/em>) for at least one minute <em><strong>[Figure 141]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1137\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-141.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-141.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-141-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 141<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">The test is positive if during exercise 1 and\/or 2 the same tingling and\/or pain symptoms as previously reported by the patient develop (<em>median nerve distribution<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">One has to realise that these tests often result in <span style=\"text-decoration: underline;\">false-negative<\/span> and <span style=\"text-decoration: underline;\">false-positive outcomes<\/span> (<em>poor sensitivity and specificity<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\"><span style=\"color: #33cccc;\"><strong> History-taking<\/strong><\/span> and <span style=\"color: #33cccc;\"><strong>EMG<\/strong><\/span> (<em>electromyography<\/em>) often provide a definitive answer.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Finkelstein Test This test is conducted when De Quervain syndrome is suspected (tenosynovitis of the abductor pollicis longus muscle and the extensor pollicis brevis muscle). Procedure Holding the wrist of the patient, carry out passive ulnar abduction, leaving the thumb free. The patient will indicate no pain or mild pain at the level of the [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[64],"tags":[141],"class_list":["post-1138","post","type-post","status-publish","format-standard","hentry","category-the-wrist-and-the-hand","tag-the-examination-of-the-upper-extremities"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Specific Tests - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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