De Quervain’s disease

De Quervain’s disease

De Quervain’s disease is caused by tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) in the first dorsal wrist extensor compartment (1st EC). It is predom - inantly seen in middle-aged females and is associated with - pregnancy (new mother’s wrist) and inflammatory arthritis. The clinical features are radial wrist pain, tenderness, swelling ( Figure 38.55 ) and a positive Finkelstein’s test (pain over the 1st EC associated with ulnar deviation of the wrist when the thumb is clasped in the palm). The management options are non-steroidal anti-inflammatories, splintage, steroid injections and surgical release of the extensor retinaculum of the first dorsal compartment. If surgery is considered, careful attention should be paid to fully releasing the APL and EPB, which frequently consist of bundles of separate tendon slips that lie in separate sheaths.

Figure 38.55 De Quervain’s disease.

De Quervain’s disease

De Quervain’s disease is caused by tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) in the first dorsal wrist extensor compartment (1st EC). It is predom - inantly seen in middle-aged females and is associated with - pregnancy (new mother’s wrist) and inflammatory arthritis. The clinical features are radial wrist pain, tenderness, swelling ( Figure 38.55 ) and a positive Finkelstein’s test (pain over the 1st EC associated with ulnar deviation of the wrist when the thumb is clasped in the palm). The management options are non-steroidal anti-inflammatories, splintage, steroid injections and surgical release of the extensor retinaculum of the first dorsal compartment. If surgery is considered, careful attention should be paid to fully releasing the APL and EPB, which frequently consist of bundles of separate tendon slips that lie in separate sheaths.

Figure 38.55 De Quervain’s disease.

De Quervain’s disease

De Quervain’s disease is caused by tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) in the first dorsal wrist extensor compartment (1st EC). It is predom - inantly seen in middle-aged females and is associated with - pregnancy (new mother’s wrist) and inflammatory arthritis. The clinical features are radial wrist pain, tenderness, swelling ( Figure 38.55 ) and a positive Finkelstein’s test (pain over the 1st EC associated with ulnar deviation of the wrist when the thumb is clasped in the palm). The management options are non-steroidal anti-inflammatories, splintage, steroid injections and surgical release of the extensor retinaculum of the first dorsal compartment. If surgery is considered, careful attention should be paid to fully releasing the APL and EPB, which frequently consist of bundles of separate tendon slips that lie in separate sheaths.

Figure 38.55 De Quervain’s disease.