De Quervains tenosynovitis (tendon inflammation)

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A patient that suffers from De Quervain’s tenosynovitis has inflammation of the tendons in the thumb. The inflammation occurs in two tendons: the extensor pollicis brevis and abductor pollicis.

De Quervain’s tenosynovitis typically is associated with pain when the thumb is folded across the palm and the fingers are flexed over the thumb as the hand is pulled away from the involved wrist area. This is also referred to as the Finklestein sign.

Symptoms of De Quervain’s tenosynovitis include finger pain, hand pain, wrist pain, and tenderness over the area where the thumb joins the wrist. Other symptoms include pain during thumb extension and hand swelling in the area where the thumb joins the wrist.

Causes and Risk factors

De Quervain’s tenosynovitis is caused by overuse of the tendons that move the thumb, which results in irritation and inflammation.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. The tendon sheath is usually the site which becomes inflamed, but both the sheath and the tendon can become inflamed simultaneously. The cause of tenosynovitis is often unknown, but usually strain, overuse, injury, or excessive exercise may be implicated. Tendonitis may also be related to disease (for example, diabetes or rheumatoid arthritis).

Diagnosis and Treatment

Finkelstein's test is used to diagnose de Quervain’s syndrome in people who have wrist pain. To perform the test, the examining physician grasps the thumb and the hand is ulnar deviated sharply. If sharp pain occurs along the distal radius (top of forearm, about an in inch below the wrist), De Quervain’s syndrome is likely.

Treatment may include splinting, nonsteroidal anti-inflammatory medications, acetaminophen, or injection of the tendon sheath with cortisone. If symptoms persist surgery may be necessary. ...

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