Understanding the Wrinkling Test (or Immersion Test) Assessment
To assess the **function of the sympathetic nervous system** and its innervation to the hand (sensory nerve integrity).
Watch How It's Done
How do I start?
Patient is sitting. Hand is submerged in warm water.
What happens?
The affected fingers/hand are submerged in **warm water (approx. 40°C)** for approximately **20 to 30 minutes**.
In Plain English
What Does a Positive Result Mean?
If the **fingertip pulp does not wrinkle** (or wrinkles less than the unaffected side), it suggests a loss of sympathetic nerve function due to a sensory nerve lesion (denervation).
Helpful Tip:
Wrinkling is a sympathetically mediated response. If the nerve supply is damaged, the wrinkling response is absent.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other Wrist/Hand Tests
Beighton Score
To quantify **generalized joint hypermobility** (laxity) across the body. The wrist/hand components assess passive joint laxity.
Bunnell-Littler Test (or Finochietto-Bunnell Test)
To differentiate between **Intrinsic Muscle tightness** (interossei and lumbricals) and **Capsular restriction** at the proximal interphalangeal (PIP) joint.
De Quervain's Tenosynovitis
This is the **condition name** (inflammation of the APL and EPB tendons), not a specific test. The Finkelstein Test is the primary diagnostic test.
Elson Test
To assess the integrity of the **Central Slip** of the Extensor Digitorum Communis (EDC) tendon, rupture of which leads to a Boutonniere deformity.