DeQuervain's tenosynovitis

Question 1

What is DeQuervain’s tenosynovitis?

Answer 1

This is inflammation of the tendon sheath within the 1st compartment (Thumb), containing the Abductor pollicis longus (APL) and extensor pollicis brevis (EPB)

Question 2

Who is most at risk of DeQuervain’s tenosynovitis?

Answer 2

Females
30-50 years
Pregnant
Rheumatoid arthritis

Question 3

How does DeQuervain’s tenosynovitis present?

Answer 3

Spontaneous pain, swelling and redness in the thumb
Pain over radial styloid at wrist
Pain radiating proximally into the forearm

Question 4

What clinical test is used in DeQuervain’s tenosynovitis?

Answer 4

Finkelstein’s test:

This involved the patient making a thumbs up, then tucking their thumb into their palm, then tipping downwards (As if pouring a kettle)

This will cause pain in cases of DeQuervain’s tenosynovitis

Question 5

What investigations are used in DeQuarvain’s tenosynovitis?

Answer 5

USS
X-ray
Both to rule out CMC osteoarthritis

Question 6

How can DeQuervain’s tenosynovitis be managed?

Answer 6

Management is usually conservative, using splinting, NSAIDs and rest

Steroid injection and decompression surgery can be used in more severe cases