Which test is used to diagnose De Quervain’s tenosynovitis?

• A. Phalen's test
• B. Finkelstein's test
• C. Mill's test
• D. Cozen's test

Answer: (B)

De Quervain’s tenosynovitis involves inflammation and narrowing of the first dorsal compartment where the abductor pollicis longus and extensor pollicis brevis tendons run. The best test to diagnose this is the Finkelstein maneuver: the patient tucks the thumb into the palm to form a fist, then the wrist is bent toward the little finger (ulnar deviation). Reproduced pain along the radial wrist or tenderness over the radial styloid during this motion strongly supports involvement of the first dorsal compartment.

Phalen’s test screens for carpal tunnel syndrome, not first dorsal compartment pathology. Mill’s test and Cozen’s test are aimed at lateral epicondylitis at the elbow, not the thumb/wrist tendons at the radial side.