VALIDITY AND RELIABILITY OF THE FINKELSTEIN´S TEST

Cheimonidou A.Z.¹, Stassinopoulos D.¹, Lamnisos D.¹, Chimonas K.¹

¹European University of Cyprus, Dep. of Health Sciences, School of Sciences, Program of Physiotherapy, Nicosia, Cyprus

Background: The Finkelstein´s test has long been considered to be probably the most
pathognomonic sign of the de Quervain´s disease. There is no study that evaluates the validity and reliability of the test although it is routinely used as a classic test in muskuloskeletal care and in research studies.

Purpose: The purpose of the study is to evaluate the validity and reliability of the Finkelstein's test.

Methods: The study is a clinical trial. 45 healthy people (age 19-48 years, 20 men, 25 women) participated in the study. The Finkelstein’s test was performed by two different professional physiotherapists and two measurements have been taken spaced one week. Also they performed the WHAT and Eichhoff test. The presence of spontaneous pain over the radial side of the styloid of the radius or no pain was analyzed as a variable and it was then analyzed using the VAS scale (0-10). To study the reliability of Finkelstein test, we evaluate the agreement between the two measurements (test - retest reliability) and between the two physiotherapists (Inter-rater reliability). The validity of the Finkelstein’s test was studied with the true negative rate and false positive rate. Furthermore, was compared with WHAT (wrist hyperflexion and abduction of the thumb) and Eichhoff´s tests using the Cohen’s Kappa coefficient.

Results: Finkelstein´s and Eichhoff´s (False Positive = 46,7% and 53,3%) tests were found positive in healthy population therefore they are not valid clinical tests in order to diagnose or evaluate De Quervain’s tenosynosvitis. The percentage of agreement with the results of WHAT test is fair (0.21–0.40) and with the results of Eichhoff test is moderate (0.41– 0.60). Reliability of the test regarding consecutive measurements on the VAS scale has fair percentage of agreement (Kappa = 0.21-0.40) and in the effect of pain or no pain has moderate percentage of agreement (Kappa = 0.41-0.60) with the results being statistically significant (p 0,05). Inter- rater reliability has moderate percentage of agreement (Kappa = 0.41-0.60) assessing the presence of pain or no pain, and fair percentage of agreement (Kappa result = 0.21–0.40) when the pain was measured with VAS scale with the results being statistically significant (p 0,05) also.

Conclusion(s): Finkelstein´s test on its own, has not been proven to be valid and reliable clinical test for assessing and diagnosing De Quervain´σ tenosynovitis.

Implications: It is suggested that future studies should concentrate on researching the reason why pain is produced in healthy people with the use of diagnostic imaging and study the anatomical or biomechanical factors that might affect the hand, resulting on a false positive outcome.

Funding acknowledgements: -

Topic: Musculoskeletal: upper limb

Ethics approval: EUC ethics committee

All authors, affiliations and abstracts have been published as submitted.