De Quervain tenosynovitis

Background

• Tenosynovitis of abductor pollicis, extensor pollicis brevis (where tendons lie in groove of radial styloid)

Clinical Features

• Pain along radial aspect of wrist (may radiate to thumb or extend into the forearm)
• Finkelstein test is positive
  • Pt grasps thumb in palm of the hand and ulnar deviates the thumb and hand
    • This stretches the tendons over the radial styloid producing sharp pain

Treatment

• Splint thumb and wrist
  • Instruct pt to remove splint briefly each day to perform range-of-motion exercises
• NSAIDs x 10-14d
• Persistent cases may require steroid injection or surgical decompression

See Also

• Hand Non-Fracture DDx

Source

• Tintinalli
• Atlas of Emergency Medicine