Tight Retinacular Test: How to Check for Finger Ligament Tightness

The Tight Retinacular Test is a diagnostic test for the finger used to differentiate between tightness in the retinacular ligaments and tightness in the PIP joint capsule. It is very similar in concept to the Bunnel-Littler test.

1. Purpose

The primary purpose is to differentiate between tightness in the finger's retinacular (collateral) ligaments and tightness (contracture) of the Proximal Interphalangeal (PIP) joint capsule. It checks why the Distal Interphalangeal (DIP) joint cannot flex.

2. How to Perform

1. The patient is positioned in sitting.

Part 1 (Test Capsule)

1. The examiner holds the patient's PIP joint in a neutral (straight) position.
2. The examiner passively flexes the DIP joint and notes the range of motion.

Part 2 (Test Ligaments)

1. The examiner moves the PIP joint into flexion.
2. While holding the PIP in flexion, the examiner again passively flexes the DIP joint and notes the range.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating an issue) is one of the following:

• Positive for Retinacular Tightness: DIP joint flexion is limited when the PIP is extended, but full when the PIP is flexed.
• Positive for Capsular Tightness: DIP joint flexion is limited in BOTH PIP extension and PIP flexion.

Negative Sign (Test is NEGATIVE):
A negative test is when full and painless DIP joint flexion is possible in both PIP positions.