De Quervain's Tenosynovitis

Inflammation of the tendon sheaths within the first compartment - contains APL and EPB

Aetiology

  • Most common in women 30-50 years
  • Associated with pregnancy and RA

Clinical presentation

Symptoms

  • Typically presents as a repetitive strain injury with pain over the radial styloid process at the wrist
    • Pain often radiates proximally into the forearm
  • Wrist usually swollen, sometimes redness

Signs

  • Finklestein's test - patient makes a fist over the thumb and the hand is ulnar deviated to reproduce pain

Investigations

  • USS and x-ray to rule out CMC joint OA which can mimic DQ

Management

Conservative

  • Splint, rest, physio, analgesics
  • Steriod injection

Surgical

  • Surgical decompression