Case

A 27yo has returned to work after maternity leave to their employment restocking an online shopping distribution warehouse. They present to the clinic with pain and swelling on the radial side of their left wrist. They have a lump approximately 1cm on the dorsal side of the left hand approximately mid-shaft on the digit 2 metacarpal that is non-painful to palpation. They indicate there has been no recent trauma and they have no history of trauma to that hand.

Question 3/3 - What tests might you perform to confirm or rule out your diagnosis of De Quervain's Tenosynovitis?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

Case Complete

Correct! This test bends the wrist into ulnar (medial) deviation.  Pain along the lateral side indicates a tension in the lateral thumb tendons (abductor pollicis longus & extensor pollicis brevis). A positive test indidates De Quervain's Tenosynovitis

Incorrect. A useful test for musculoskeletal injury, but not required for diagnosis of De Quervain's Tenosynovitis.

Incorrect. Ulnar claw sign is an indication of distal ulnar nerve injury. This is performed by the patient's hand starting in a closed fist and the patient asked to extend their fingers. If they cannot extend digits 4&5 that indicates distal ulnar nerve dysfunction.

Incorrect. Median claw sign is an indicator of distal median nerve injury. This is performed by the patient's hand starting in a closed fist and the patient asked to extend their fingers. If they cannot extend digits 2&3 that indicates distal median nerve dysfunction.  

Incorrect. This test is for carpal tunnel syndrome. A Tinel's test is performed by a compression/tap on the location of the carpal tunnel, if there is construction the median nerve carpal tunnel symptoms will be elicited by the compression/tap.

Incorrect. Ape hand refers to a muscle wasting in the thenar eminence and inability to oppose or flex the thumb. This indicates injury to the recurrent branch of the median nerve. 

Incorrect. Generally a Frankenstein Test is applied during an English literature course on Mary Shelly's writings. Rarely of value for assessing musculoskeletal injury.

Incorrect. Pope's Blessing sign is an indication of proximal median nerve injury. This is performed by the patient's hand starting with the fingers extended and they are asked to close their hand. If only digits 4&5 flex that indicates only the ulnar nerve in the forearm is working and there is a proximal median nerve injury.

Incorrect. The OK Gesture sign is an indication of proximal ulnar nerve injury. This is performed by the patient's hand starting with the fingers extended and they are asked to close their hand. If only digits 2&2 flex that indicates only the median nerve in the forearm is working and there is a proximal ulnar nerve injury.