De Quervain's tenosynovitis
Definition
De
Quervain's tenosynovitis is inflammation of tendons on the side of
the wrist at the base of the thumb. These tendons include the extensor pollicis
brevis and the abductor pollicis longus tendons.
Review anatomy
Cause
- Idiopathic
- Excessive repetitive movement
-
Grasping, pinching, squeezing, or
wringing may lead to the inflammation of tenosynovitis
- Other causes include:
:Direct
injury to your wrist or tendon; scar tissue can restrict movement of the
tendons
:RA
Sign and symptom
- pain, tenderness, and swelling over the thumb side of the wrist, and difficulty gripping.
If the condition goes too long without treatment,
the pain may spread farther into the thumb and forearm. Pinching, grasping and
other movements of the thumb and wrist aggravate the pain
Investigate
- The Finkelstein test
flexion of the thumb across the palm and then
ulnar deviation of the wrist) causes sharp pain at the first dorsal compartment
Treatment
- Non-medical
-Immobilizing the thumb and wrist, keeping them straight with a splint
or brace to help rest the tendons
: thumb-spica
splint
:Radial
forearm based static Wrist-Thumb Orthosis
- Anti-inflammatory medications
- Cortisone injection
- Surgery is only rarely necessary and usually reserved for persisting inflammation after failure of at least one cortisone injection.
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