Curriculum · Musculoskeletal / Orthopedic / Rheumatology
De Quervain tenosynovitis
What it is
In De Quervain tenosynovitis the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed.
Causes and risk
It usually occurs with repeated use of the thumb, and the age given for it is 30-50 years. The pain may have been long standing by the time the patient is seen: one case is a 60-year-old right hand dominant female telemarketer with long standing radial sided wrist pain, particularly when making calls.
How it presents
There is pain on the radial side of the wrist, with tenderness over the radial styloid process. The pain is sharp in quality and is localized 1.5cm proximal to the radial styloid. Abduction of the thumb against resistance is painful, and the pain is felt at the base of the thumb. The symptoms are worse when the patient clasps the thumb in the palm and the wrist is forced into ulnar deviation.