Wrist & Hand Special Tests: The Complete Clinical Assessment Guide

Wrist and hand special tests are most useful when chosen to confirm or refute a hypothesis from the history - nocturnal hand paraesthesia points to carpal tunnel, radial wrist pain with thumb use to De Quervain's, and ulnar-sided weakness to ulnar nerve involvement. This guide groups the tests that change management, with how to perform each one and how to interpret a positive or negative result.

Special tests

Provocation tests for the median nerve - most useful as a cluster alongside the history and sensory testing.

  • Phalen's test
  • Tinel's sign at the wrist

Special tests

  • Finkelstein test
  • Froment's sign

Frequently asked questions

How do you test for carpal tunnel syndrome?

Combine Phalen's test and Tinel's sign at the wrist with the history and sensory testing of the thumb, index and middle fingers. No single test is conclusive - interpret them as a cluster.

What is the Finkelstein test for?

It assesses De Quervain's tenosynovitis. With the thumb tucked into a fist and the wrist deviated toward the little finger, sharp pain over the radial styloid suggests inflammation of the first dorsal compartment tendons.

What does a positive Froment's sign mean?

When pinching paper, flexion of the thumb's end joint to keep hold indicates weakness of adductor pollicis and points to ulnar nerve dysfunction.