Introduction:

Finkelstein sign is a clinical maneuver used to assess for the presence of De Quervain's tenosynovitis, a condition that causes inflammation of the tendons in the wrist. This comprehensive article aims to provide a thorough understanding of Finkelstein sign, including its technique, diagnostic significance, associated conditions, and management strategies.

Understanding Finkelstein Sign:

Finkelstein sign is a physical examination technique used to evaluate the presence of De Quervain's tenosynovitis. It involves a specific movement of the thumb that elicits pain along the affected tendons in the wrist. This maneuver is performed by making a fist with the fingers wrapped over the thumb and then moving the wrist towards the little finger.

Diagnostic Significance of Finkelstein Sign:

Finkelstein sign is highly specific for De Quervain's tenosynovitis, which is characterized by inflammation of the extensor pollicis brevis and abductor pollicis longus tendons. A positive Finkelstein sign is indicated by the presence of pain along the radial aspect of the wrist during the maneuver. However, it is important to note that Finkelstein sign alone is not sufficient to establish a diagnosis, and further evaluation and clinical correlation are required.

Associated Conditions and Differential Diagnosis:

While Finkelstein sign is most commonly associated with De Quervain's tenosynovitis, it is important to consider other conditions that may present with similar symptoms. Differential diagnoses to consider include:

• Intersection syndrome
• Wartenberg syndrome
• Radial tunnel syndrome
• Scaphoid fracture
• Thumb carpometacarpal joint osteoarthritis

Management of De Quervain's Tenosynovitis:

The treatment of De Quervain's tenosynovitis aims to reduce pain and inflammation, promote healing, and restore normal wrist and thumb function. Management strategies may include:

• Rest and activity modification: Avoiding activities that aggravate symptoms and providing rest to the affected hand and wrist.
• Immobilization: Wearing a thumb spica splint or a brace to restrict thumb and wrist movement.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation.
• Physical therapy: Stretching and strengthening exercises for the thumb and wrist to improve range of motion and strength.
• Corticosteroid injections: Injecting corticosteroids into the tendon sheath to alleviate inflammation and pain.
• Surgical intervention: In rare cases where conservative measures fail, surgical release of the tendon sheath may be considered.

Conclusion:

Finkelstein sign is a valuable clinical maneuver for assessing De Quervain's tenosynovitis, a condition characterized by inflammation of the tendons in the wrist. By understanding the technique, diagnostic significance, associated conditions, and management strategies, healthcare providers can effectively evaluate and manage individuals presenting with thumb and wrist pain.

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