A positive Finkelstein test is most specific for stenosing tenosynovitis of which tendon group?

• A. Abductor Pollicis Longus and Extensor Pollicis Brevis Tendons
• B. Extensor Pollicis Longus Tendon
• C. Abductor Pollicis Brevis Tendon
• D. Flexor Pollicis Longus Tendon

Answer: (A)

Finkelstein test is used to diagnose De Quervain’s tenosynovitis, which is stenosis of the first dorsal compartment of the wrist. That compartment contains two tendons: abductor pollicis longus and extensor pollicis brevis. When you tuck the thumb into the palm and passively flex the wrist toward the ulnar side, these tendons glide within their sheath. If the sheath is inflamed and narrowed, this movement produces pain at the radial styloid, making the test positive.

So, the test is most specific for stenosing tenosynovitis of the tendons in that first dorsal compartment—APL and EPB. Pain with this maneuver is not typically produced by pathology of the extensor pollicis longus (which is in a different compartments and related tests) or by flexor pollicis longus or ABP tendon issues, which involve other anatomical structures and maneuvers.