De Quervain tenosynovitis: Difference between revisions
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**Or even texting | **Or even texting | ||
==Clinical Features== | ==Clinical Features<ref>Keon-Cohen B. De Quervain disease. J Bone Joint Surg Br. 1951;33-B(1):96-99 http://www.jbjs.org.uk/cgi/reprint/33-B/1/96.</ref>== | ||
*Pain along radial aspect of wrist (may radiate to thumb or extend into the forearm) | *Pain along radial aspect of wrist (may radiate to thumb or extend into the forearm) | ||
*Finkelstein | *Painful abduction of thumb | ||
*Decreased grip strength | |||
*Swelling at tendon sheath along radial styloid | |||
*Positive Finkelstein, pathognomonic | |||
**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 | ||
** | **Stretches the tendons over the radial styloid producing sharp pain | ||
*Negative Phalen and Tinel test | |||
==Differential Diagnosis== | ==Differential Diagnosis== |
Revision as of 21:50, 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[2]
- Pain along radial aspect of wrist (may radiate to thumb or extend into the forearm)
- Painful abduction of thumb
- Decreased grip strength
- Swelling at tendon sheath along radial styloid
- Positive Finkelstein, pathognomonic
- Pt grasps thumb in palm of the hand and ulnar deviates the thumb and hand
- Stretches the tendons over the radial styloid producing sharp pain
- Negative Phalen and Tinel test
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.
- ↑ Keon-Cohen B. De Quervain disease. J Bone Joint Surg Br. 1951;33-B(1):96-99 http://www.jbjs.org.uk/cgi/reprint/33-B/1/96.