Trigger Finger Physical Exam Findings Form
Trigger Finger Physical Exam Findings Form
Patient Name or Initials
*
Date of Examination
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hand Examined
*
Left
Right
Both
Finger Examined
*
Please Select
Thumb
Index
Middle
Ring
Little
Multiple
Symptom Duration (weeks)
*
Pain Severity (0 = none, 10 = worst)
*
None
0
1
2
3
4
5
6
7
8
9
Worst
10
0 is None, 10 is Worst
Locking or Catching Frequency
*
Please Select
Never
Occasionally
Frequently
Constantly
Tenderness Location
*
Please Select
None
A1 Pulley
Flexor Tendon
Other
Swelling or Palpable Nodule
*
None
Swelling
Nodule
Range of Motion Limitation or Triggering Observed
*
Full flexion
Full extension
Flexion limitation
Extension limitation
Triggering observed
Clinician Impression or Notes
Submit Exam Findings
Should be Empty: