Physical Examination of Hand

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 5 min read
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Examination of the hand is an essential piece of a hand surgeon's skill set. This current concepts review presents a systematic process of performing a comprehensive physical examination of the hand including vascular, sensory, and motor assessments. The examination of the hand and nails can...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Examination of the hand is an essential piece of a hand surgeon's skill set. This current concepts review presents a systematic process of performing a comprehensive physical examination of the hand including vascular, sensory, and motor assessments. The examination of the hand and nails can lead to a number of diagnoses. Some of these include liver disease (Terry's nails), kidney disease (Lindsay's nails), lung disease...

Key Takeaways

  • This article explains Inspection in simple medical language.
  • This article explains Palpation in simple medical language.
  • This article explains Range of Motion in simple medical language.
  • This article explains Strength and Neurovascular in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

Examination of the hand is an essential piece of a hand surgeon’s skill set. This current concepts review presents a systematic process of performing a comprehensive physical examination of the hand including vascular, sensory, and motor assessments. The examination of the hand and nails can lead to a number of diagnoses. Some of these include liver disease (Terry’s nails), kidney disease (Lindsay’s nails), lung disease (nail clubbing), endocarditis, and many others. Evaluations focused on specific hand diseases and injuries are also discussed. This information can be useful for any health care provider treating patients with hand conditions.

Introduction

  • Follows the IP-PASS examination methodology
    • Inspection
    • Palpation
    • Passive Range of Motion
    • Active Range of Motion
    • Strength & Neurovascular
    • Special Tests

Inspection

  • Skin
    • Color: allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।" data-rx-term="erythema" data-rx-definition="Erythema means skin redness, often from irritation, allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।">erythema, ecchymosis, pallor, black
    • Trophic changes (altered hair growth, sweat production)
    • Scars
  • Swelling
  • Muscle tone
    • Thenar atrophy: Median Nerve injury
    • Interosseus atrophy: Ulnar Nerve Injury
  • Deformity
    • Asymmetry
    • Radial or ulnar deviation
    • Rotation
    • Amputation
    • Athritic nodes
    • Butonniere
    • Swan Neck
  • Angulation: Cascade Sign

Palpation

  • Joint Effusion
  • Clicking
  • Snapping
  • Crepitus
  • pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">Tenderness
  • Temperature
  • Masses

Range of Motion

  • Finger
    • MCP: 0° – 85°
    • PIP: 0° – 110°
    • DIP: 0° – 65°
  • Wrist
    • Flexion: 60°
    • Extension: 60°
    • Radioulnar Deviation: 50°

Strength and Neurovascular

  • Sensation
    • Recommend: 2 point discrimination (use paper clip)
    • Light touch
  • Motor:
    • Median Nerve: “A-OK” sign: flexion of thumb and index finger or thumb and pinky against resistance
    • Ulnar Nerve: Test fingers against resistance in abduction
    • Radial Nerve: Test thumb extension against resistance
  • Vascular
    • Radial pulse
    • Ulnar pulse
    • Allen’s Test

Special Tests

  • De Quervains Tenosynovitis
    • Finkelstein’s Test
    • Eichhoff’s Test
  • Central Slip Extensor Tendon Injury
    • Elson’s Test
  • Gamekeeper’s Thumb
    • UCL Stress Test (Thumb)
  • TFCC Injury
    • TFCC Shear Test
    • TFCC Stress Test
  • Wartenbergs Syndrome
    • Tinel’s Test
    • Finkelstein’s Test
  • Carpal Tunnel Syndrome
    • Tinels Test
    • Phalens Test
    • Durkan’s Test
  • Scapholunate Instability
    • Scaphoid Shift Test
  • Lunotriquetral Instability
    • Reagans Test
    • Kleinman’s Shear Test
  • Distal Radial Ulnar Joint Instability
    • Piano Key Test
  • Carpometacarpal pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">Arthritis
    • Thumb CMC Grind Test
  • Special tests
    • Palpation
      • grind test
        • used to test for pathology at the thumb carpometacarpal joint (CMC)
        • examiners apply axial load to the first metacarpal and rotate or “grinds” it
        • positive findings: pain, crepitus, instability
      • Finkelstein’s 
        • used to test for DeQuervain’s tenosynovitis
        • the patient makes a fist with fingers overlying the thumb
        • examiner gently ulnar deviates the wrist
        • positive findings: pain along with the 1st compartment
    • Range of motion
      • flexor profundus 
        • used to test the continuity of FDP tendons
        • MCP + PIP joints were held in extension while the patient asked to flex FDP, thereby isolating FDP (from FDS) as the only tendon capable of flexing the finger
      • flexor sublimus 
        • used to test for continuity of FDS tendon
        • MCP, PIP, and DIP of all fingers held in extension with hand flat and palm up; the finger to be tested is then allowed to flex at PIP joint.
      • Bunnel’s test
        • examiner passively flexes PIPJ twice
          • first with MCP in extension
          • next MCP held an inflection
        • intrinsic tightness present if PIP can be flexed easily when MCP is flexed but NOT when MCP is extended
        • extrinsic tightness present if PIP can be flexed easily when MCP is extended but NOT when MCP is flexed
    • Stability assessment
      • scaphoid shift test (Watson’s test) 
        • tests for a scapholunate ligament tear
        • examiner places a thumb on the distal pole of the scaphoid on the palmar side of the wrist and applies constant pressure as the wrist is radially and ulnarly deviated
        • dorsal wrist pain or “clunk” may indicate instability
      • lunotriquetral ballottement 
        • tests for a lunotriquetral ligament tear
        • examiner secures the pisotriquetral unit with the thumb and index finger of one hand and the lunate with the other hand
        • anterior and posterior stresses are placed on the LT joint
        • positive findings are increased laxity and accompanying pain
      • midcarpal instability
        • examiner stabilizes distal radius and ulna with the non-dominant hand and moves patients wrist from radial deviation to ulnar deviation, whilst applying an axial load
        • a positive test occurs when a clunk is felt when the wrist ulnar deviates
      • ulnar carpal abutement
        • tests for TFCC tear or ulnar-carpal impingement
        • examiner ulnarly deviates wrist with axial compression
        • positive if the test reproduces pain or a ‘pop’ or ‘click’ is heard
      • Gamekeeper’s 
        • tests for ulnar collateral ligament tear at MCP of thumb
        • examiner stresses first MCPJ into radial deviation with MCPJ is fully flexed and extended positions
        • positive test if > 30 degrees of laxity in both positions (or gross laxity compared to another side)
    • Nerve assessment
      • Tinel’s 
        • tests for carpal tunnel syndrome
        • examiner percusses with two fingers over the distal palmar crease in the midline
        • positive if the patient reports paresthesias in median nerve distribution
      • Phalen’s 
        • tests for carpal tunnel syndrome
        • with the hands pointed up, the patient’s wrist is allowed to flex by gravity in palmar flexion for 2 minutes maximum
        • positive if the patient reports paresthesias in median nerve distribution
      • Froment’s sign
        • tests for ulnar nerve motor weakness
        • the patient asked to hold a piece of paper between the thumb and radial side of the index
        • positive if as the paper is pulled away by the examiner the patient flexes the thumb IP joint in an attempt to hold on to paper 
      • Wartenberg’s sign 
        • tests ulnar nerve motor weakness
        • a patient asked to hold fingers fully adducted with MCP, PIP, and DIP joints fully extended
        • positive if a small finger drifts away from others into abduction
      • Jeanne’s sign 
        • tests for ulnar nerve motor weakness
        • ask patient to demonstrate key pinch
        • positive finding if patient’s first MCP joint is hyperextended
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Physical Examination of Hand

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

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