What is the normal capsular pattern for the carpometacarpal joints?

• A. Flexion > Extension
• B. Abduction and Adduction limited
• C. Flexion = Extension
• D. Extension > Flexion

Answer: (C)

The main idea here is how a joint capsule constrains movement, producing a characteristic capsular pattern. For the carpometacarpal joints of the digits 2 through 5, the capsule tends to tighten in a way that limits movement in flexion and extension by about the same amount. Abduction and adduction are not as consistently restricted early on, so the typical and most diagnostic pattern is equal limitation of flexion and extension. That’s why the best answer is that flexion and extension are equally limited.