AIIMS November 2011 – MCQ 57

Which of the following tests is not required to arrive at a diagnosis in a patient with pain in the thumb, index finger and middle finger?
A. Finkelstein test
B. Phalen’s test
C. Tinel’s sign
D. Tourniquet test

Correct answer : A. Finkelstein test

Pain in the thumb, index finger and middle finger is suggestive of carpal tunnel syndrome. Phalen’s test, Tinel’s sign and Tourniquet test are all useful for diagnosis of carpal tunnel syndrome.

Finkelstein’s test is used to diagnose DeQuervain’s tenosynovitis in people who have wrist pain.

Phalen’s test:
Findings on physical examination often include a positive Phalen’s test. During this test, the patient holds their wrist in full, unforced, palmar flexion. The development of any sensory disturbance such as numbness, tingling, or burning pain within 60 seconds is diagnostic for carpal tunnel syndrome.

Tinel’s sign:
Tapping lightly on the underside of the wrist (just proximal to the wrist joint), over the median nerves may cause shooting (electric shock) pains.

Tourniquet test:
The tourniquet test may also be performed in patients with suspected carpal tunnel syndrome. The development of numbness and tingling in the fingers after an inflated blood pressure cuff is placed on the upper arm suggests carpal tunnel syndrome.

Ref: www.freemd.com/carpal-tunnel-syndrome/evaluation.htm