The Bunnel-Littler test helps identify the source of PIP tension or flexion motion limitation by evaluating the intrinsic muscle or capsular tightness in the affected digit. This test may also be used to determine osteoarthritis.
- Patient should be seated and cooperative.
- Locate and extend the MCP joint and flex the PIP joint. Take note of the range of motion of the affected digit.
- Repeat the procedure but this time the MCP joint should be flexed.
Positive Bunnel-Littler Test
- A positive Bunnel-Littler test means there is decreased motion which could be due to joint capsule contraction or osteoarthritis.
- If there is no change in motion after the two tests were performed, capsular restriction at the PIP joint may be present.
- If motion is increased when the MCP joint is flexed then lumbricale muscle tightness may be present.