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DeQuervain's Stenosing Tenosynovitis
Description
The tendons that straighten the fingers and thumb travel on the back of the wrist, and are held down to the wrist by a series of tunnels, or pulleys. When the tendons that straighten the thumb become swollen and inflamed as they pass through one of the tunnels, it becomes painful to use the thumb. Repeated use of the thumb only causes more swelling and inflammation of these tendons.
Common Causes
Repeated use of the hands and thumb, especially pinching, gripping or squeezing. Gardening, knitting, keyboarding etc.
Symptoms
Pain in the wrist, with use of the thumb
Physical Findings
Tenderness, and occasional swelling along the thumb extensor tendons. A positive Finklestein's test.
Workup
History and physical exam is usually sufficient. Occasionally, x-rays are obtained to rule out other causes of pain, such as arthritis.
Non-Operative Treatment
Splinting, anti-inflammatory medication, and a trial of a corticosteroid injection into the tendon sheath.
Surgical Treatment
Release of the band, or part of the tunnel that is causing constriction of the tendons.
Comments
Non-operative treatment is usually successful. Surgical release is generally curative, and can be performed with local anesthesia, often in an office setting.
Related Information
AAOS Online
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Wrist / Hand Injuries
