Execution
- 1Position the patient’s forearm so the wrist and fingers can be tested against resistance.
- 2Identify the third digit.
- 3Resist extension of the third digit distal to the proximal interphalangeal joint.
- 4Palpate or monitors pain over the lateral epicondyle during resisted middle-finger extension.
- 5Compare pain and weakness with the opposite side and screen for radial nerve features when needed.
Positive outcome
Pain over the lateral epicondyle is positive. Weakness without local lateral-epicondyle pain may suggest posterior interosseous nerve involvement rather than classic lateral epicondylalgia.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Karanasios et al. (2022) — systematic review | NA | NA | NA | NA | NA |
| Roles & Maudsley (1972) | NA | NA | NA | NA | NA |
CommentMagee specifically notes the dual interpretation risk: pain supports lateral epicondylalgia, while painless weakness may indicate posterior interosseous nerve syndrome. This makes the test useful for differential reasoning but weak as a standalone tendon test. Diagnostic-accuracy data are heterogeneous and limited.
Low Clinical Value