De Quervain's Tenosynovitis

 

What is DeQuervain's tenosynovitis?

Keratoacanthomas are rapidly growing lesions in the superficial layers of the skin that often develop into a 1-2 cm dome and involute into a crater like ulcerous/necrotic lesions.  

What Symptoms is associated with

De Quervain's?

Patients with de Quervain’s tenosynovitis experience pain and swelling at the base of the thumb often extending up the forearm, they can also experience spasms, tenderness and an occasional burning sensation causing a difficulty in gripping. 

These symptoms often occur with excessive gripping or when engaged in repetitive movements of the wrist.

What is the cause ?

De Quervain’s tenosynovitis is typically caused by repetitive trauma to the wrist such as with activities that requires repetitively movements such as gripping or straining of the wrist.

how do I know if I have

De Quervain's?

De Quervain’s Tenosynovitis is a clinical diagnosis meaning there is no tests to perform to access whether you have the condition or not.  The pain at the base of the thumb and increase in pain when the wrists is deviated to the opposite side of the arm (Finkelstein’s test) is indicative of the syndrome.

 
 
 

how Long will it Be until my function recovers 

completely?

Resolution of symptoms is dependent on the patient’s degree of inflammation.  A protective splint to prevent excessive movement of the thumb after steroid injections can often help the inflammation in the thumb settle faster.

prevention

To help with the recovery and resolution of symptoms, limiting the use of hands as much as possible after an injections and wearing a protective splint to support the wrist when engaged in repetitive activities will help reduce symptoms and recurrence of the syndrome.

What IS THE Management of

De Quervain's?

Treatment of de Quervain’s tenosynovitis includes conservative management such as:

  1. splinting to immobilize the wrist to allow inflammation to settle

  2. applying ice to the affected area

  3. using anti-inflammatory medications

  4. steroid injections to reduces inflammation

Reducing the inflammation at the wrist will help with reduction of the pain and tenderness experienced.

Surgical management where the compartment that contains the inflamed tendons is opened up,  is an alternative to management of de Quervain’s tenosynovitis.  However, this surgery is rarely performed.

Is Surgery Recommended?

Conservative management including steroid injections should be attempted before surgery.  It is recommended that 3 attempts of steroid injections into the tunnel be made before progressing to surgical management.

 
 
 
 
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