Palpation of the flexor tendons of the hand

The flexor tendon is palpated for tenderness or cyst formation. The hand is placed with the palm up on the exam table and with the fingers extended. The flexor tendon is palpated along its entire course from the distal interphalangeal (DIP) joint through the palm to the wrist. If a cyst is felt, passive movement of the finger is performed to determine if the cyst is intratendinous (cyst moves with finger movement) or peritendinous (cyst does not move). The arrow indicates the site of maximal tenderness over the first annular (A1) pulley of the tendon sheath.