Carpopedal spasm is associated with a characteristic posture described as which of the following?

• A. Abduction of the thumb, flexion of MCP, extension of interphalangeal joints, flexion of the wrist
• B. Adduction of the thumb, flexion of MCP, extension of interphalangeal joints, flexion of the wrist
• C. Abduction of the little finger, MCP flexion, IP extension, wrist extension
• D. Abduction of the thumb, flexion of MCP, extension of interphalangeal joints, flexion of the wrist

Answer: (D)

Carpopedal spasm reflects hypocalcemic tetany driven by increased neuromuscular excitability. The hand assumes a claw-like posture: the wrist flexes, the metacarpophalangeal joints flex, the interphalangeal joints extend, and the thumb adducts toward the palm. This combination of finger joint positions and thumb position best matches the description you’d expect in this sign. The thumb moves toward the palm (adduction) rather than away from it (abduction), and the other joints align to produce the characteristic claw-like hand.