Test for Intrinsic Tightness Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing tightness of the Intrinsic Muscles (Interossei/Lumbricals).
How to Perform
- Action: Hold MCP joint in extension and flex the PIP. Then flex the MCP and flex the PIP.
Interpretation of Results
- Positive Test: PIP flexion is limited when MCP is extended, but improves when MCP is flexed.
Clinical Context & Limitations
The Test for Intrinsic Tightness 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 Test for Intrinsic Tightness with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
