Bunnell Littler Test

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The Bunnel Litter Test

First, the MCP joint is first held in extension, whereas the PIP joint is passively flexed, noting the flexion angle (A). The MCP joint is then held in flexion, and the PIP joint is flexed again (B). If the PIP joint flexes more with MCP flexion, intrinsic muscle contracture or spasticity is present. To avoid confusion between intrinsic and extrinsic muscle involvement, this test should be performed with the wrist in flexion if FDS/FDP contracture is indicated by the Volkmann angle.

• Bunnell's intrinsic tightness test
• Bunnell Littler Test
• Finochietto-Bunnell Test
• Bunnell Test

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Purpose

• Helps identify the source of PIP tension or flexion motion limitation by evaluating the intrinsic muscle or capsular tightness in the affected digit.
• May also be used to determine osteoarthritis.

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Description

• Locate and extend the MCP joint and flex the PIP joint. Take note of the range of motion of the affected digit.
• Repeat the procedure but this time the MCP joint should be flexed.
• Positive Test
  • Decreased motion, suggesting capsule contraction or osteoarthritis
  • No change in motion, sugests capsular restriction at PIP joint
  • Increased motion, lumbrical muscle tightness may be present

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Pathology

• Osteoarthritis of the finger
• Capsule contraction of PIP joint
• Lumbrical muscle tightness

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Evidence

• None

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See Also

• Finger Pain Main
• Physical Exam Hand

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