Wrist/Hand Ortho Exams

Question 1

Percuss over the flexor retinaculum of the wrist and the Tunnel of Guyon. (+) = tingling into lateral 3 fingers or medial 2 fingers.

Answer 1

Tinel’s Sign at the Wrist

* Carpal tunnel syndrome or Ulnar nerve impingement

Question 2

The patient flexes the wrists maximally and holds position for up to 60 seconds by pushing both wrists together. (+) = tingling into the first 3 digits of the hand

Answer 2

Phalen’s Sign

* Carpal Tunnel syndrome

Question 3

The doctor places a piece of paper between the patients thumb and index finger and attempts to pull the paper out. (+) = Unable to keep paper between fingers

Answer 3

Froment’s Paper Sign

* Ulnar nerve palsy

Question 4

The pt is asked to make a fist with thumb tucked inside. The fist is then ulnar deviated. This evaluates the Extensor Pollicis Brevis and Abductor Pollicis Longus. (+) = pain over the anatomical snuff box

Answer 4

Finkelstein’s test

* DeQuervain’s Dx aka Stenosing Tenosynovitis