WHAT test (wrist hyperflexion + abduction of the thumb)
For: De Quervain's tenosynovitis
Painful irritation of two thumb tendons (abductor pollicis longus and extensor pollicis brevis) and their sheath where they run over the thumb side of the wrist.
Treat with caution (see below)Its negative likelihood ratio reaches the usual rule-out threshold, but the book does not count it as a reliable rule-out test.
Caution: Single study, not replicated; the specificity rests on only about 7 people without the condition.
What the numbers mean
- Positive result: barely informative: a positive result changes little.
- Negative result: see the caution above before relying on this result.
Source
Goubau JF, Goubau L, Van Tongel A, Van Hoonacker P, Kerckhove D, Berghs B. The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff's test. J Hand Surg Eur. 2014;39(3):286–292. PubMed · single study
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 2 October 2026.
Get the book for how to do and read each wrist and hand test with published figures, and which carpal tunnel test to trust
This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
Coming in late 2026 as a PDF and a paperback. Join the list to hear when it's out
One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.