Match the following upper extremity musculoskeletal conditions with their classic physical examination findings or provocative test results.
- De Quervain tendinopathyPain at the radial styloid provoked by ulnar deviation of the wrist with the thumb grasped inside a closed fist
- Lateral epicondylitisElbow pain exacerbated by resisted wrist extension and supination
- Medial epicondylitisElbow pain exacerbated by resisted wrist flexion and forearm pronation
- Stenosing tenosynovitisPalpable nodule at the metacarpophalangeal joint with catching or locking during digit movement
- Carpal tunnel syndromeParesthesias in the thumb, index, and middle fingers provoked by tapping the volar wrist
Answer
The correct matches are: De Quervain tendinopathy with pain on ulnar deviation; Lateral epicondylitis with pain on resisted wrist extension; Medial epicondylitis with pain on resisted wrist flexion; Stenosing tenosynovitis with catching/locking at the MCP joint; and Carpal tunnel syndrome with paresthesias on volar wrist tapping.
Each condition is a classic upper extremity pathology with a highly specific physical examination finding. De Quervain tendinopathy is identified by the Finkelstein test. Lateral and medial epicondylitis involve the common extensor and flexor tendons, respectively. Stenosing tenosynovitis presents with a triggering digit due to A1 pulley thickening. Carpal tunnel syndrome is identified by a positive Tinel or Phalen sign.
Step-by-Step Solution
Key Concept
Diagnosis of upper extremity tendinopathies and compressive neuropathies relies heavily on specific provocative maneuvers that isolate and stress the involved anatomical structures.