A 60-year-old man with progressive clawing of the ring and little fingers undergoes an intrinsic tightness test (Finochietto test). The MCP joints are passively flexed and resistance to PIP extension is noted. When the MCP joints are passively hyperextended, PIP extension becomes even more limited. This finding indicates:

• A Extensor tendon rupture
• B Intrinsic muscle contracture ✓
• C PIP joint capsular contracture
• D Flexor tendon adhesion

Explanation

In the intrinsic tightness test (Bunnell test), if PIP extension worsens when the MCP is hyperextended (increasing intrinsic stretch), it confirms intrinsic contracture. If PIP extension improves with MCP hyperextension, it indicates capsular contracture of the PIP joint. The test differentiates intrinsic tightness from joint contracture in claw hand deformity.

Reference: Green's Operative Hand Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.