DeQuervain's Disease

Question 1

What happened, man?

Answer 1

Tenosynovitis (Strain) of APL and EPB along lateral wrist and base of thumb

Question 2

What’s my old name?

Answer 2

Tenovaginitis

Question 3

What caused me?

Answer 3

Stenosing tenosynovitis is severe chronic form!

Question 4

Ddx

Answer 4

Intersection syndrome
OA
RA
Blood work nec to r/o RA

Question 5

What causes me man?

Answer 5

Forceful hyperext and or hyperabd of thumb
Repetitive overuse (twist wrist, pinch grip, racket sports, hand tools, typing)
Texting, age risk is increasingly younger
Prior history of wrist tendinopathy
Cyclists (Vibration and shifting gears)

Question 6

What are some signs yo

Answer 6

Swelling without bruising
P w/ resisted thumb extension adn when stretching tendons
FINKELSTEIN’S TEST

Question 7

Symptoms?

Answer 7

Gradual onset and unclear MOI
Local P w/ pain referral
Tenderness
Decreased grasping/pinching
Squeaky thumb

Question 8

Early tx

Answer 8

POLICE, elim/modify offending activity completely

Question 9

Intersection syndrome

Answer 9

Similar presentation as DQ but w/ lateral wrist pain
Repetitive injury to ECRB/L
Repetitive wrist motion rather than thumb motion
Squeaky wrist

Question 10

1st Carpo-MC OA

Answer 10

Age, prior thumb injury, DJD elsewhere
Joint enlargement
Grinding crepitis
\+ thumb grind test
Manip/mob
Xrays if possible!