De Quervain tenosynovitis: Difference between revisions
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**Pt grasps thumb in palm of the hand and ulnar deviates the thumb and hand | **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 | ***This stretches the tendons over the radial styloid producing sharp pain | ||
==Differential Diagnosis== | |||
{{Hand and finger injury DDX}} | |||
==Diagnosis== | |||
==Treatment== | ==Treatment== | ||
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*[[Radiograph-Negative Hand and Finger Injuries]] | *[[Radiograph-Negative Hand and Finger Injuries]] | ||
== | ==References== | ||
*Tintinalli | *Tintinalli | ||
*Atlas of Emergency Medicine | *Atlas of Emergency Medicine | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 06:48, 1 June 2015
Background
- Tenosynovitis of abductor pollicis, extensor pollicis brevis (where tendons lie in groove of radial styloid)
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
- Tintinalli
- Atlas of Emergency Medicine