Finkelstein test !

Maneuver

Bending the thumb while the wrist tilts toward the little finger causes sharp pain at the edge of the wrist when the thumb tendons are inflamed.

Updated 2026-11-01

See it in 3D: APL · APL and EPB tendons · EPB · Radius · Extensor retinaculum

What it is

The Finkelstein test stretches the tendons of the first dorsal compartment of the wrist and reproduces the pain of de Quervain tenosynovitis. The version most often taught is really the Eichhoff maneuver (thumb tucked in the fist), which gives more false positives. It is a quick, useful test in postpartum women and in people who use the thumb heavily.

The anatomy it tests

The first dorsal compartment of the wrist holds the abductor pollicis longus and extensor pollicis brevis tendons.
Both run through a tight fibro-osseous tunnel over the radial styloid, under the extensor retinaculum.
Flexing the thumb with the wrist in ulnar deviation stretches these tendons inside a thickened, inflamed sheath, and that reproduces the pain.

How to do it

Patient seated, forearm resting on the edge of the table in neutral (thumb up) with the wrist free.
Finkelstein: ask the patient to tilt the wrist toward the little finger (ulnar deviation).
The examiner grasps the patient's thumb and flexes it passively into the palm.
Eichhoff variant: the patient tucks the thumb inside the fist and the examiner deviates the whole hand toward the ulnar side.
Ask where it hurts and watch the patient's face; then repeat on the healthy side.
Positive: sharp pain over the radial styloid and the radial edge of the wrist.
Palpate the first dorsal compartment, just above the radial styloid, for tenderness, thickening or crepitus.

What a positive result means

Suggests de Quervain tenosynovitis: inflammation and thickening of the sheath of the first extensor compartment.
Common in women, after childbirth, in people lifting an infant and in work or sport that loads the thumb.
Differential diagnosis: trapeziometacarpal osteoarthritis, scaphoid fracture and intersection syndrome.
The Eichhoff variant can hurt in healthy people: a positive result with that technique is read with caution.

Usefulness and limits

In a comparative study, the original Finkelstein test was more specific than the Eichhoff maneuver.
The diagnosis is clinical; ultrasound shows the thickened sheath when in doubt.

Test yourself

Think of the answer, then tap the question to see it.

Which tendons are involved in de Quervain tenosynovitis?

Abductor pollicis longus and extensor pollicis brevis, in the first dorsal compartment of the wrist.

Where is the pain in a positive Finkelstein test?

Over the radial styloid, on the radial edge of the wrist.

How does the Eichhoff maneuver differ from the Finkelstein test?

In Eichhoff the patient tucks the thumb in the fist and the examiner deviates the whole hand; in Finkelstein, with the wrist already in ulnar deviation, mainly the thumb is flexed.

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See it in 3D

The structures of Durgical's 3D anatomy where it is found.

De Quervain tenosynovitis

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Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Sources: Finkelstein's Test Is Superior to Eichhoff's Test in the Investigation of de Quervain's Disease (Journal of Hand and Microsurgery (PubMed Central), 2018); Musculo-Skeletal Examination – Hand Exam – Practical Guide to Clinical Medicine (UC San Diego School of Medicine, 2026).

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