Wrist & Hand
Tendon Injury
Evidence: confirmed
Elson Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Central Slip Injury (precursor to Boutonniere Deformity).
How to Perform
- Position: Finger flexed 90° over table edge.
- Action: Patient tries to extend the PIP joint against resistance.
Interpretation of Results
- Positive Test: Weak PIP extension, but the DIP joint goes rigid/extends (lateral bands pull tight).
- Normal: Strong PIP extension, DIP remains loose.
Clinical Context & Limitations
The Elson Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Elson Test with complementary examination tests significantly improves overall diagnostic confidence.
