De Querviain’s syndrome is a painful condition that affects two of the tendons we discussed in a previous article in this series: the extensor pollicis brevis and the abductor pollicis longus. These two tendons are practically side by side and have very related functions—they both move the thumb away from the hand. This combination injury got its name from a Swiss surgeon named Fritz De Quervain, who first identified it in 1895. Finkelstein’s test, named for the surgeon who developed it, is specifically designed to test for this condition.

Confirming Your Suspicions

Although you can be reasonably certain that the client has De Quervain’s syndrome if they feel pain on both resisted extension of the thumb (which tests the extensor pollicis brevis) and resisted abduction of the thumb (which tests the abductor pollicis longus), Finkelstein’s test provides useful confirmation of this injury.

To perform this test:

1.      Ask the client to bend their elbow at 90 degrees and make a fist with their thumb beneath their fingers.

2.      Gently grasp the client’s forearm with one hand and their fist with the other hand. Then, with the client relaxed and passive, bring their fist into ulnar deviation.

Pain on this stretch indicates De Quervain’s. In some cases, you may notice the sound of crepitus coming from the tendon as the client bends and straightens it, as well as very mild swelling.