What is the normal capsular pattern for the metacarpophalangeal joints of digits 2-5?

• A. Flexion > Extension (+/-2:1)
• B. Flexion = Extension
• C. Extension > Flexion
• D. Abduction and Adduction limited

Answer: (A)

The main idea here is how a joint’s capsule dictates a characteristic pattern of motion loss. For the metacarpophalangeal joints of digits 2–5, the capsule tends to tighten most in flexion, so flexion is the more limited movement compared with extension. The typical relationship is about 2:1, meaning you lose roughly twice as much range in flexion as in extension. So the best description is that flexion is limited more than extension, with a flexion-to-extension limitation around 2:1.

This fits because the other patterns don’t match how these MCP joints typically stiffen: extending is less restricted than flexing, equal restriction would be unusual, and limiting only abduction/adduction isn’t the primary capsular pattern for these joints.