Description

A test for diagnosing de Quervain tenosynovitis, or snapping thumb syndrome.

Confusion exists over the exact description of performing Finkelstein’s test as opposed to Eichhoff Test – a descriptive error that can produce a false positive. [J Hand Surg Br, 1992]

  • Physical examination is normal
  • Aetiology is unknown but patients usually have a normal life span
  • Also referred to as “Effort Syndrome” as symptoms resemble those of fatigue following effort in healthy individuals

History of the Finkelstein Test

1930 – Review of surgical operation, histology and clinical examination led Finkelstein to summise

On grasping the patient’s thumb and quickly abducting the hand ulnarward, the pain over the styloid tip is excruciating. This is probably the most pathognomonic objective sign.

Finkelstein H. JBJS 1930: 522

*1927 – An alternative test suggested by E. Eichhoff was accurately transposed from the German and quoted in Finkelstein’s 1930 paper in full. This led to confusion regarding the anatomics of the testing procedure aggravated by a poor description of the test by Leão (1958); and further augmented by later authors.

A simple experiment will verify this assumption. If one places the thumb within the hand, and holds it tightly with the fingers, and then bends the hand severely, in ulnar abduction, an intense pain is experienced on the styloid process of the radius, exactly at the place where the tendon sheath takes its course. The pain disappears the moment the thumb is extended, even if the ulnar abduction is maintained. In cases of forced abduction of the hand, without simultaneous involvement of the thumb, one does not succeed in evoking this pain. Thus, repeated overstretching of the tendon sheath results in injury to the gliding mechanism.

Eichhoff E. 1927: 513
Finkelstein Test and Eichhoff test
Finkelstein Test and Eichhoff test for tenosynovitis of the first extensor compartment
A: Finkelstein Test; holding thumb whilst hand forced into ulna deviation
B: Eichhoff test; grasping thumb in palm of hand whilst wrist is ulna deviated
  • Physical examination is normal
  • Aetiology is unknown but patients usually have a normal life span
  • Also referred to as “Effort Syndrome” as symptoms resemble those of fatigue following effort in healthy individuals

Associated Persons
  • Physical examination is normal
  • Aetiology is unknown but patients usually have a normal life span
  • Also referred to as “Effort Syndrome” as symptoms resemble those of fatigue following effort in healthy individuals

Alternative names
  • Modified Eichhoff test
  • Physical examination is normal
  • Aetiology is unknown but patients usually have a normal life span
  • Also referred to as “Effort Syndrome” as symptoms resemble those of fatigue following effort in healthy individuals

References

Historical references

Review references


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the names behind the name

Dr Ronan McKenna, MB BCh BAO at National University of Ireland Galway. Living in Australia with  plans for a future in Emergency Medicine. A keen interest in Medical History, Wilderness Medicine and Sport.

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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