Certified Hand Therapist (CHT) Practice Exam

What condition can be indicated by limited motion on both the DIP and PIP during the oblique retinacular ligament test?

1. Extrinsic tendon tightness

2. Intrinsic tightness

3. Joint contracture

4. Tendon rupture

The correct answer is: Joint contracture

Limited motion at both the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints during the oblique retinacular ligament test typically suggests a joint contracture. This test assesses the function of the oblique retinacular ligament, which connects the PIP joint to the DIP joint, thereby influencing their motion relative to each other. When a joint contracture is present, the ability to flex either joint is restricted, impacting the overall range of motion in the finger. The simultaneous limitation at both joints indicates a problem intrinsic to the joint itself rather than being primarily caused by extrinsic factors like tendon tightness or ruptures. Joint contractures can occur due to various reasons, including prolonged immobilization, adhesions from past injuries, or conditions like arthritis. In contrast, while intrinsic or extrinsic tendon tightness affects finger motion, each condition presents unique patterns in motion that do not consistently limit both joints. For instance, extrinsic tendon tightness typically limits the PIP motion more than that at the DIP joint. Similarly, tendon rupture would lead to specific motion deficits that may not equally restrict both joints at the same time. Recognizing joint contractures as the primary concern when observing limitations at both the DIP and