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Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. [2] Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. [2]
Infectious tenosynovitis is the infection of closed synovial sheaths in the flexor tendons of the fingers. It is usually caused by trauma, but bacteria can spread from other sites of the body. Although tenosynovitis usually affects the flexor tendon of the fingers, the disease can also affect the extensor tendons occasionally. [5]
Trapeziometacarpal osteoarthritis (TMC OA) is, also known as osteoarthritis at the base of the thumb, thumb carpometacarpal osteoarthritis, basilar (or basal) joint arthritis, or as rhizarthrosis. [ 3 ] [ 1 ] [ 2 ] This joint is formed by the trapezium bone of the wrist and the metacarpal bone of the thumb.
The examiner passively restricts the flexion of the fingers while the examinee attempts to actively flex the thumb. [10] A positive test is marked by restricted active thumb flexion with pain or cramping discomfort in the palmar and radial sides of the distal (lower) forearm or wrist. [10]
Diagnosis is typically based on symptoms and signs after excluding other possible causes. [2] Trigger digits can resolve without treatment. Treatment options that are disease modifying include steroid injections and surgery. [3] Splinting immobilization of the finger may or may not be disease modifying.
Finkelstein's test was described by Harry Finkelstein (1865–1939), an American surgeon, in 1930. [5]A similar test was previously described by Eichhoff, in which the thumb is placed in the palm of the hand and held with the fingers, and the hand is then ulnar deviated (see images), causing intense pain over the radial styloid which disappears if the thumb is released.
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Pain may be caused after exerting the wrist, as may occur during weight lifting, in any weight-bearing or athletic activity, manual labor, or from injury to nerves, muscles, ligaments, tendons or bones of the wrist. [2] [3] Wrist pain may result from nerve compression, tendonitis, osteoarthritis or carpal tunnel syndrome.
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