Wrist Hyperflexion and Abduction of the Thumb (WHAT) Test: Difference between revisions
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<div class="editorbox"> '''Original Editor '''- [[User:User Name|Trista Chan]]<br> | <div class="editorbox"> '''Original Editor '''- [[User:User Name|Trista Chan]]<br> | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | ||
== Purpose == | == Purpose == | ||
[[De Quervain's Tenosynovitis]] is a condition involving the abductor pollicis longus and extensor pollicis brevis tendons in the first extensor compartment of the wrist<ref>Satteson E, Tannan SC. [https://www.ncbi.nlm.nih.gov/books/NBK442005/ De Quervain Tenosynovitis []Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK442005/</nowiki> | [[De Quervain's Tenosynovitis]] is a condition involving the [[Abductor Pollicis Longus|abductor pollicis longus]] (AbPL) and [https://search-api.swiftype.com/api/v1/public/modules/click.json?redirect_url=https%3A%2F%2Fwww.physio-pedia.com%2FExtensor_Pollicis_Brevis%3Futm_source%3Dphysiopedia%26utm_medium%3Drelated_articles%26utm_campaign%3Dongoing_internal&document_id=6090f4dd28ccbc8d57a26894&key=em_Lw9Ddy5qjk_a6tsnJEaC extensor pollicis brevis] (EPB) tendons in the first extensor compartment of the wrist<ref>Satteson E, Tannan SC. [https://www.ncbi.nlm.nih.gov/books/NBK442005/ De Quervain Tenosynovitis []Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK442005/</nowiki> | ||
</ref>. Different tests has been used to identify De Quervain's disease, with the [[Finkelstein Test|Finkelstein's test]] being one of the common diagnostic tests<ref name=":0">Wu F, Rajpura A, Sandher D. [https://pubmed.ncbi.nlm.nih.gov/30154628/ 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: <nowiki>https://pubmed.ncbi.nlm.nih.gov/30154628/</nowiki> | </ref>. Different tests has been used to identify De Quervain's disease, with the [[Finkelstein Test|Finkelstein's test]] being one of the common diagnostic tests<ref name=":0">Wu F, Rajpura A, Sandher D. [https://pubmed.ncbi.nlm.nih.gov/30154628/ 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: <nowiki>https://pubmed.ncbi.nlm.nih.gov/30154628/</nowiki> | ||
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</ref>. The Finkelstein's test is often confused with the Eichhoff's test<ref name=":0" /><ref name=":1">Goubau JF, Goubau L, Van Tongel A, Van Hoonacker P, Kerckhove D, Berghs B. [https://pubmed.ncbi.nlm.nih.gov/23340762/ 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. | </ref>. The Finkelstein's test is often confused with the Eichhoff's test<ref name=":0" /><ref name=":1">Goubau JF, Goubau L, Van Tongel A, Van Hoonacker P, Kerckhove D, Berghs B. [https://pubmed.ncbi.nlm.nih.gov/23340762/ 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. | ||
</ref>, thus the Wrist hyperflexion & Abduction of the Thumb test is developed in 2014 as an alternative test for De Quervain's disease<ref name=":1" />.<br> | </ref>, thus the Wrist hyperflexion & Abduction of the Thumb test is developed in 2014 as an alternative test for De Quervain's disease<ref name=":1" />. The WHAT test being an active test, it better isolates the AbPL & EPB tendons and eliminates the excursion mechanism of the tendons<ref name=":1" />. | ||
[[File:Stenosing tendondosynvitis of thumb De Quervain.jpg|center|frameless|400x400px| | |||
</ref>]] | |||
<br> | |||
== Technique == | == Technique == | ||
{{#ev:youtube|v=FlFMFhrbWwM}}<ref>www.youtube.com. (n.d.). ''Wrist Hyperflexion Abduction of the Thumb / WHAT Test | De Quervain’s Disease''. [online] Available at: https://www.youtube.com/watch?v=FlFMFhrbWwM [Accessed 27 Jun. 2023]. | |||
</ref> | |||
== | === Procedure<ref name=":1" />: === | ||
# 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<ref name=":1" />: === | |||
Pain reproduction indicates positive test for De Quervain's Tenosynovitis | |||
== | == Evidence == | ||
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<ref name=":1" />.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<ref name=":1" />. | |||
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<references /> | <references /> | ||
[[Category:Wrist]] | |||
[[Category:Wrist - Special Tests]] | |||
[[Category:Wrist - Assessment and Examination]] | |||
Latest revision as of 09:26, 28 June 2023
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].
Technique[edit | edit source]
Procedure[3]:[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[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]
- ↑ 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.
- ↑ www.youtube.com. (n.d.). Wrist Hyperflexion Abduction of the Thumb / WHAT Test | De Quervain’s Disease. [online] Available at: https://www.youtube.com/watch?v=FlFMFhrbWwM [Accessed 27 Jun. 2023].
