Wrist Hyperflexion and Abduction of the Thumb (WHAT) Test

Original Editor - Trista Chan
Top Contributors - Trista Chan and Carina Therese Magtibay

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Purpose[edit | edit source]

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[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].

Stenosing tendondosynvitis of thumb De Quervain.jpg


Technique[edit | edit source]

The patient is seated in a comfortable position. They then actively hyperflex their wrist and abduct their thumb. The examiner then resists the movement with their index finger. Pain reproduction indicates positive test for De Quervain's Tenosynovitis

Evidence[edit | edit source]

  • The WHAT test has a sensitivity of 0.99 and specificity of 0.29[3]
  • Limited studies is available, so further investigations need to be done for the reliability and validity of the WHAT test.

Resources[edit | edit source]

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 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. ‌