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Sensitivity and Specificity

How is it performed?

  • The higher the grade the worse the disability becomes and damage occurs to the pyramidal tract, it seems less likely to be reversed but further scientific studies need to be done
  • While testing patients it is also crucial to determine whether they have wrist flexion/extension because it can display cases of a motor neuron disease or peripheral nerve involvement.
  • First, is placed with wrist in neutral position and forearm fully pronated.
  • Next, patient is ask to adduct their fingers for 30 seconds. A positive sign is indicated when the fifth digit can't be held in adduction.
  • However, patients who show a positive sign can stiff abduct the fifth digit and can also oppose it to the thumb.

Finger Escape Test

Pathology!

The finger escape sign is deficiency in adduction and/or extension of the last three or last two fingers.

Pathology continued......

  • Cervical spinal stenosis causes impingement on the nerve root (C7 and C8) which results in patients complaining of a "clumsy" hand.
  • Patient suffer from numbness and tingling which is a result of a spinal cord disorder such as myelopathy, secondary of spinal spondylosis.
  • The last stage patients experience is loss of motor functions in hands and fingers.

Myelopathy -> refers to the pathology of the spinal cord

More Severe Cases...

  • Patients most susceptible to having a positive finger escape sign are patients 45+ because at this age degeneration starts to occur. The vertebrae begins to degenerate as well as the discs between, which is referred to as spondylosis. Due to this degeneration the the vertebrae compresses against each other causing a term referred to as cervical spinal stenosis (narrowing of the spinal canal in the neck). It can also be caused by boney spurs which are boney projections that develop along the edge of bones. They often form where bones meet each other.
  • In more advanced cases, the tendency to abduct is seen in the ring finger in addition to the fifth digit. Also, there is a clear increase in abduction at rest of the last three digits. With that, patients also lose full extension in their interphalangeal joints of the ulnar fingers.
  • As the disability becomes even more worse, patient's ulnar fingers become significantly flexed at the metacarpophalangeal joints, leaving patients with only their index finger and thumb mobile.

By: Adam Zarr and Kayla Argudo

Why does this happen?

Patients who test positive for the finger escape sign have a lesion of the C8 nerve root, which is a neuropraxia injury.

As a result of this sign, patients are graded based upon 5 grades.

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