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DeQuervain's Tenosynovitis

What is deQuervains tenosynovitis?

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Updated June 09, 2014

Wrist Pain and Mouse
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DeQuervain's tenosynovitis is a condition that causes pain associated with movement of the thumb. The cause of the pain of deQuervain's is inflammation within a confined area around the base of the thumb and wrist. This inflammation is called 'stenosing tenosynovitis.' This simply means that the inflammation involves the synovium and tendons that control the movement of the thumb.

Who is susceptible to deQuervain's tenosynovitis?
DeQuervain's tenosynovitis is most common in the 30-50 year old age group, and is seen more commonly in women. DeQuervain's tenosynovitis is due to excessive use of the wrist. It is commonly seen in new mothers as the motion of picking up the baby can cause irritation to these wrist tendons.

How is the diagnosis of deQuervain's tenosynovitis made?
The examination of deQuervain's is usually quite typical with tenderness over the involved tendons. One specific maneuver called 'Finkelstein's test' is quite specific for this condition. Finkelstein's test is performed by making a fist and moving the wrist towards the small finger. Patients with deQuervain's tenosynovitis will have pain with this maneuver.

What is the treatment of deQuervain's tenosynovitis?
Most patients with deQuervain's tenosynovitis will find improvement with wrist splinting and a cortisone injection.

Is surgery needed for the treatment of deQuervian's tenosynovitis?
If the problem persists, a surgical procedure to create more room for the tendons can be performed. During this surgical procedure the tight tissue around the tendons is cut to release the restriction on tendon motion. Surgery can be performed under local, regional, or general anesthesia. After surgery, a splint is worn for a few weeks, and normal activities can be gradually resumed.

Sources:

Ilyas AM "de Quervain Tenosynovitis of the Wrist" J. Am. Acad. Ortho. Surg., December 2007; 15: 757 - 764.

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