Wrist Hyperflexion & Abduction of the Thumb (WHAT) Test

Original Editor - Trista Chan
Top Contributors - Trista Chan

Purpose[edit | edit source]

De Quervain's Tenosynovitis is a condition involving the abductor pollicis longus (AbPL) and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist[1]. Different tests has been used to identify De Quervain's disease, with the Finkelstein's test being one of the common diagnostic tests[2]. The Finkelstein's test is often confused with the Eichhoff's test[2][3], thus the Wrist hyperflexion & Abduction of the Thumb test is developed in 2014 as an alternative test for De Quervain's disease[3]. The WHAT test being an active test, it better isolates the AbPL & EPB tendons and eliminates the excursion mechanism of the tendons[3].

Stenosing tendondosynvitis of thumb De Quervain.jpg

Technique[edit | edit source]

Procedure[3]:[edit | edit source]
  1. The patient is seated in a comfortable position.
  2. They are asked to actively hyperflex their wrist and abduct their thumb.
  3. The examiner then resists the movement with their index finger.
Interpretation[3]:[edit | edit source]

Pain reproduction indicates positive test for De Quervain's Tenosynovitis

Evidence[edit | edit source]

A study found that The WHAT test is more accurate as compared to traditional diagnostic test for De Quervain's, with a sensitivity score of 0.99 and specificity score of 0.29[3].However, the study involved a small sample size and only two experienced surgeons. Therefore, further investigations need to be done to confirm the reliability and validity of the test[3].

References[edit | edit source]

  1. Satteson E, Tannan SC. De Quervain Tenosynovitis [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442005/ ‌
  2. 2.0 2.1 Wu F, Rajpura A, Sandher D. Finkelstein’s Test Is Superior to Eichhoff’s Test in the Investigation of de Quervain’s Disease. Journal of Hand and Microsurgery [Internet]. 2018 Aug 1;10(2):116–8. Available from: https://pubmed.ncbi.nlm.nih.gov/30154628/ ‌
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Goubau JF, Goubau L, Van Tongel A, Van Hoonacker P, Kerckhove D, Berghs B. The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff’s Test. Journal of Hand Surgery (European Volume). 2013 Jan 22;39(3):286–92. ‌