Wartenberg's sign, Froment's sign, and a positive intrinsic tightness test are all positive in a patient with ulnar nerve palsy at the elbow. Which specific test differentiates intrinsic tightness from extrinsic (FDP/joint capsule) tightness in the ring finger?
- A Allen's test
- B Finkelstein test
- C Bunnell's intrinsic tightness test (MCP joint positioned in extension vs flexion and comparing PIP passive flexion) ✓
- D Phalen's test
Correct answer: C. Bunnell's intrinsic tightness test (MCP joint positioned in extension vs flexion and comparing PIP passive flexion)
Explanation
Bunnell's intrinsic tightness test: With the MCP joint held in extension (stretching intrinsics), passive PIP flexion is tested. If PIP flexion is restricted in MCP extension but free when MCP is in flexion (relaxing intrinsics), intrinsic tightness is confirmed. If PIP flexion is equally restricted regardless of MCP position, the tightness is due to extrinsic flexor tendon adhesion or capsular contracture. This distinction guides whether intrinsic release or extrinsic tenolysis/capsulotomy is needed.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.