Bunnel-Littler PIP Joint Test on Physical Exam For intrinsic vs joint capsule cause of restriction or tightness in the PIP joint preventing full flexion - start with unaffected side and compare 1) Extend finger at MCP joint & passively flex finger at PIP 2) Flex MCP & passively flex at the PIP, compare 3) If PIP flexion is limited in MCP extension=intrinsic muscles tightness or joint capsule tightness 4) If tightness is STILL prsents when MCP Flexed, likely due joint capsule 5) If tight PIPJ in MCP extension, but not w/MCP flexion, then likely due to tight intrinsic muscles (Also, a lot easier to do with both hands, but 🤳🏽) - Lil Bone Peep @peds_sports_med #Bunnel #Littler #BunnelLittler #Test #PhysicalExam #clinical #video #msk #PIP
