de Quervain Tenosynovitis

Question 1

de Quervain Tenosynovitis
______ or _____ of the sheath that surrounds the abductor pollicis longus and extensor pollicis brevis tendon at the wrist.

Answer 1

Swelling or stenosis

Question 2

Definition

(1) Precipitated by repetitive use of _____
(2) Pain, swelling and triggering phenomenon results in locking or sticking of the tendon as the patient moves the thumb
(3) Commonly affects middle-aged _____

Answer 2

1) thumb

3) women

Question 3

Dx / Tx
Clinical Symptoms
(1) Pain at radial aspect of the wrist exacerbated by movement of thumb or wrist
(2) Occasionally may be edema
Physical Exam
(1) Visual = Swelling may be present is the distal radius region
(2) Palpation = Tenderness over the radial styloid
(3) ROM = Usually normal
(4) Strength = Normal
(5) Neurovascular = Intact
(6) Special tests = Positive Finkelstein Test

Answer 3

de Quervain Tenosynovitis
Treatment
(1) NSAIDs
(2) Thumb spica splint
(3) Light duty- activity modification

Question 4

Diagnostic Test

(1) Diagnosed ______
- -(a) Plain films not required
(2) May be obtained if concern for _________

Answer 4

1) clinically

2) fracture or other bone pathology

Question 5

Referral Decisions and Red Flags

(1) ______ consult with failed conservative management

Answer 5

Orthopedic