De Quervain disease

De Quervain Disease: A Painful Condition Affecting the Wrist and Thumb

De Quervain disease, also known as de Quervain tenosynovitis or de Quervain's tendinosis, is a painful condition that affects the tendons in the wrist. It occurs when the tendons of two muscles, abductor pollicis longus and extensor pollicis brevis, become constricted by their tendon sheath in the wrist [12][13].

Causes and Symptoms

The exact cause of de Quervain disease is unknown, but it is believed to be caused by repetitive hand or wrist movement, such as working in the garden, playing golf or racket sports, or lifting a baby [1]. The symptoms of de Quervain disease include pain and swelling in the tendons around the thumb, particularly near the base of the thumb. This pain can radiate into the forearm [14].

Common Activities that May Trigger De Quervain Disease

Activities that involve repetitive gripping with the hand and bending of the wrist, such as racket sports (e.g., tennis or racquetball), golf, or any activity where you grip with your hand and bend your wrist over and over again, can trigger de Quervain disease [15].

Treatment Options

De Quervain syndrome is treated by reducing the swelling/irritation of the tendons and tendon sheath, thereby relieving the pain caused by the condition. Nonsurgical treatment options include wearing a splint to keep the wrist straight and the thumb still in a comfortable position, which may improve pain, especially when worn at night [11].

Prevalence

De Quervain's tenosynovitis is one of the most common forms of tenosynovitis, affecting many people worldwide. It is essential to seek medical attention if you experience any symptoms or discomfort in your wrist or thumb.

References: [1] - Context result 1 [11] - Context result 11 [12] - Context result 12 [13] - Context result 13 [14] - Context result 14 [15] - Context result 15

Understanding De Quervain Disease: Signs and Symptoms

De Quervain disease, also known as de Quervain tenosynovitis, is a painful condition that affects the tendons on the thumb side of the wrist. The symptoms can vary from person to person, but here are some common signs and symptoms:

• Pain at the base of the thumb: Pain or tenderness at the base of the thumb, especially when moving the thumb or wrist.
• Wrist pain: Pain or discomfort on the thumb side of the wrist, which can radiate to the forearm and thumb.
• Swelling and redness: Mild swelling, redness, or warmth at the wrist, indicating inflammation.
• Pain with activities: Pain when performing activities that involve repetitive hand or wrist movement, such as working in the garden, playing golf or racket sports, or lifting a baby.

These symptoms can be caused by compression of the two tendons that pass through the wrist near the lower thumb, leading to pain and inflammation. It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help alleviate discomfort and prevent further complications.

References:

• [1] Symptoms of De Quervain’s Tenosynovitis.
• [3] Understanding de Quervain's disease: Explore its causes, symptoms, and treatment options.
• [5] De Quervain syndrome is a painful condition that occurs when the two tendons that control movement of the thumb and their tendon sheath becomes inflamed.
• [7] Symptoms of De Quervain Tenosynovitis · Wrist pain on the thumb side · Thumb and wrist pain with twisting or grasping · Swelling on the thumb side of the wrist ...
• [9] Signs and Symptoms ... The symptoms of De Quervain's tenosynovitis include pain and tenderness on the side of the wrist at the base of the thumb. You may also ...
• [11] If you have de Quervain tenosynovitis, you will probably feel pain when you turn your wrist, grasp anything or make a fist.
• [13] Pain and tenderness on the thumb side of your wrist may be due to de Quervain’s tenosynovitis.

De Quervain disease, also known as de Quervain’s tenosynovitis, is a condition that affects the tendons on the thumb side of the wrist. There are several diagnostic tests used to diagnose this condition.

Common Diagnostic Tests

• Finkelstein Test: This test involves making a fist with your fingers wrapped over your thumb and then moving your wrist up and down. If you experience pain or discomfort, it may indicate de Quervain disease [1].
• Eichhoff Test: Similar to the Finkelstein test, this test involves placing your thumb in your palm and bending it towards your other fingers. If you experience pain or discomfort, it may indicate de Quervain disease [4].
• Finkelstein/Eichhoff Test: This test combines elements of both the Finkelstein and Eichhoff tests to assess for de Quervain disease [4].

Other Diagnostic Tests

• WHAT Test (Wrist Hyperflexion and Abduction of Thumb): This is a relatively new orthopedic test used to diagnose de Quervain disease. It involves hyperflexing the wrist and abducting the thumb, which

De Quervain disease, also known as de Quervain tenosynovitis, can be treated with various medications to reduce inflammation and relieve pain.

Corticosteroid injections: Corticosteroid injections are often used as a first-line treatment for de Quervain disease. These injections help to reduce swelling and inflammation in the affected tendon sheath, thereby relieving pain and discomfort [7]. A study by D Challoumas in 2023 found that patients with de Quervain tenosynovitis who received local corticosteroid injections with thumb spica immobilization for 3 to 4 weeks had a higher rate of treatment success compared to those who received corticosteroid injections alone [7].

Oral medications: Oral medications such as NSAIDs (non-steroidal anti-inflammatory drugs) and corticosteroids can also be used to manage pain and inflammation associated with de Quervain disease. However, these medications may not be effective for everyone and may have side effects [5].

Other treatments: In some cases, other treatments such as splints or orthoses may be recommended to help immobilize the affected area and reduce pain and discomfort.

It's essential to note that while medication can provide relief from symptoms, it is crucial to address the underlying cause of de Quervain disease, which often involves modifying activities and taking regular breaks to rest the affected wrist and thumb. Consultation with a healthcare professional is recommended for proper diagnosis and treatment planning.

References: [5] - Symptoms of de Quervain’s tenosynovitis [7] - Patients with de Quervain tenosynovitis should receive a local corticosteroid injection with thumb spica immobilization for 3 to 4 weeks as first-line treatment.

De Quervain disease, also known as De Quervain tenosynovitis, can be challenging to diagnose due to its similarity in symptoms with other conditions affecting the wrist and thumb. Here are some differential diagnoses that should be considered:

• Thumb CMC arthritis: This condition affects the joint at the base of the thumb and can cause pain and stiffness in the thumb.
• Intersection syndrome: This is a condition that occurs when the tendons of the forearm intersect, causing pain and swelling in the wrist.
• FCR (Flexor Carpi Radialis) tendinitis: This is an inflammation of the tendon that connects the forearm to the wrist, which can cause pain and stiffness in the wrist.
• Tenosynovitis related to inflammatory arthropathies: Conditions such as rheumatoid arthritis can cause inflammation in the tendons and synovial fluid surrounding them, leading to symptoms similar to De Quervain disease.

These conditions should be ruled out through a combination of clinical evaluation, imaging studies (such as X-rays or ultrasound), and laboratory tests. A thorough medical history and physical examination are essential to determine the correct diagnosis.

According to [12], differential diagnosis for De Quervain's tenosynovitis includes:

• Thumb CMC arthritis
• Intersection syndrome
• FCR tendinitis

Additionally, [13] mentions that plain radiographs may help rule out other pathologies associated with radial wrist pain.