Examination of the hand and fingers can be helpful in screening a patient for Marfan Syndrome or a related connective tissue disorder such as Loeys-Dietz Syndrome.


Features to look for:

(1) arachnodactyly with fingers that are long and thin

(2) thumb sign

(3) Walker-Murdoch wrist sign

(4) finger joint hypermobility or hypomobility with flexion contractures (camptodactyly)


The thumb sign is positive if the entire distal phalanx of the thumb projects beyond the ulnar border of the hand when it is laid across the palm over the fifth metacarpal bone.


The Walker-Murdoch wrist sign is positive when the entire distal phalanx of the thumb overlaps the entire distal phalanx of the fifth finger when they are placed to encircle the opposite wrist.


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