De Quervain's Tenosynovitis

Question 1

What is De Quervain’s Tenosynovitis?

Answer 1

Reactive thickening of the tendon sheath around EPB and APL
Occurs spontaneously (idiopathic) or by overuse of the thumb
Overuse - eccentric lowering of the wrist into ulnar deviation with load
+women, +new mothers, 40-50s
Inflamation, swelling and thickening of synovial sheaths
Adhesion between sheath and tendon cause restriction
Enclosed tendons can become constricted

Question 2

What are the clinical presentations of De Quervain’s Tenosynovitis?

Answer 2

Pain on radial side of the wrist/ thumb
Aggravated - resisted thumb extension/ abduction
Or stretching the affected tendon (Finkelstein’s Test
Pain on palpation of tendon

Question 3

What are ways to manage De Quervain’s Tenosynovitis?

Answer 3

NSAID’s
Splinting 
Corticosteroid injections 
Surgery
Load Management 
Exercise
Education