De Quervain tenosynovitis: Difference between revisions
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==Background== | ==Background== | ||
*Tenosynovitis of abductor pollicis, extensor pollicis brevis | *Tenosynovitis of abductor pollicis, extensor pollicis brevis | ||
**Groove of radial styloid | |||
**First extensor compartment | |||
*30-50 yoa, more common in women | |||
*Overuse of the thumb<ref>Ashurst JV et al. Tenosynovitis Caused by Texting: An Emerging Disease. The Journal of the American Osteopathic Association, May 2010, Vol. 110, 294-296.</ref> | |||
**Classically mothers that frequently lift infants | |||
**Or secretarial, nursing occupations | |||
**Or even texting | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 21:43, 29 May 2016
Background
- Tenosynovitis of abductor pollicis, extensor pollicis brevis
- Groove of radial styloid
- First extensor compartment
- 30-50 yoa, more common in women
- Overuse of the thumb[1]
- Classically mothers that frequently lift infants
- Or secretarial, nursing occupations
- Or even texting
Clinical Features
- Pain along radial aspect of wrist (may radiate to thumb or extend into the forearm)
- Finkelstein test is positive
- Pt grasps thumb in palm of the hand and ulnar deviates the thumb and hand
- This stretches the tendons over the radial styloid producing sharp pain
- Pt grasps thumb in palm of the hand and ulnar deviates the thumb and hand
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Diagnosis
Treatment
- Splint thumb and wrist
- Instruct pt to remove splint briefly each day to perform range-of-motion exercises
- NSAIDs x 10-14d
- Persistent cases may require steroid injection or surgical decompression
See Also
References
- Diop AN, Ba-Diop S, Sane JC et-al. [Role of US in the management of de Quervain's tenosynovitis: review of 22 cases] J Radiol. 2008;89 (9 Pt 1): 1081-4.
- Sawaizumi T, Nanno M, Ito H. De Quervain's disease: efficacy of intra-sheath triamcinolone injection. Int Orthop. 2007;31 (2): 265-8.
- ↑ Ashurst JV et al. Tenosynovitis Caused by Texting: An Emerging Disease. The Journal of the American Osteopathic Association, May 2010, Vol. 110, 294-296.