College of Massage Therapists of British Columbia (CMTBC) Practice Exam

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What deformity is indicated by a "bowstring" effect of the extensor digitorum tendons at the MCP joint?

Trigger finger
Ulnar drift
Boutonnière deformity
Swan Neck deformity

The correct answer is: Ulnar drift

The "bowstring" effect of the extensor digitorum tendons at the metacarpophalangeal (MCP) joint is indicative of ulnar drift. This condition is characterized by the lateral deviation of the fingers towards the ulnar side of the hand at the MCP joints. It occurs due to the weakening of the ligaments and tendons that stabilize the joints, often associated with conditions such as rheumatoid arthritis. As the extensor tendons lose their proper alignment and support, they are pulled laterally, creating the visual effect of bowstringing, where the tendons appear tense or pulled away from their usual path. Other conditions, while related to finger and joint deformities, do not present with this specific bowstringing phenomenon. For example, trigger finger involves a digit that becomes stuck in a flexed position due to a narrowing of the sheath. Boutonnière deformity presents as a flexion at the PIP joint and extension at the DIP, and swan neck deformity involves hyperextension at the PIP joint and flexion at the DIP joint, both of which manifest differently and do not create the bowstringing effect seen in ulnar drift.