Wrist Hyperflexion & Abduction of the Thumb (WHAT) Test
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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. Different tests has been used to identify De Quervain's disease, with the Finkelstein's test being one of the common diagnostic tests. The Finkelstein's test is often confused with the Eichhoff's test, thus the Wrist hyperflexion & Abduction of the Thumb test is developed in 2014 as an alternative test for De Quervain's disease. The WHAT test being an active test, it better isolates the AbPL & EPB tendons and eliminates the excursion mechanism of the tendons.
Technique[edit | edit source]
Procedure:[edit | edit source]
- The patient is seated in a comfortable position.
- They are asked to actively hyperflex their wrist and abduct their thumb.
- The examiner then resists the movement with their index finger.
Interpretation:[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.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.
References[edit | edit source]
- ↑ 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/
- ↑ 2.0 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/
- ↑ 3.0 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.