De Quervain's Tenosynovitis: Difference between revisions
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== Clinically Relevant Anatomy<br> == | == Clinically Relevant Anatomy<br> == | ||
De Quervain's tenosynovitis involves the abductor pollicis longus and the extensor pollicis brevis tendons. Both muscles and tendons extend the thumb backwards or move the thumb away from the palm, radial abduction. These tendons perform similar movement and run from the forearm to the thumb. | |||
== Mechanism of Injury / Pathological Process<br> == | |||
Usually caused by a new repetitive activity such as gardening, knitting, racket sports, or work tasks. In the technology age is has been nicknamed “Blackberry Thumb”<sup>1</sup><br> | |||
== Clinical Presentation == | == Clinical Presentation == | ||
DeQuervains occurs in women 8-10 times more often than men.<sup>2</sup> The condition can be sudden or gradual. Presents most commonly with pain and/or swelling on the radial side of the wrist at the base of the thumb (first dorsal compartment). Symptoms increase with pinching, grasping, and gripping activities. Pain at the thumb and wrist can progress up the forearm. New mothers are prone to this due to child care tasks with lifting, holding and feeding placing the hand in awkward positions; as well as hormonal changes.<sup>3</sup> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Finkelstein test <br> | |||
== Management / Interventions<br> == | |||
Non Operative:<br>Rest: activity modification and use of brace/splint for the thumb and wrist. <br>Anti-inflammatory: oral medication, phonophoresis, inotophoresis, or cold packs.<br>Injection: steroid | |||
<br>Surgery: <br>The sheath of the first dorsal compartment is opened longitudinally for decompression.<br> | |||
== Differential Diagnosis<br> | == Differential Diagnosis<br> == | ||
1. Osteoarthritis of the first CMC joint<sup>1,4</sup><br>2. Intersection syndrome – pain will be more towards the middle of the back of the forearm and about 2-3 inches below the wrist<sup>1,4</sup><br>3. Wartenberg’s Syndrome - isolated neuritis of the superficial radial nerve, can be caused by tight jewelry<sup>1,4</sup><br><br> | |||
== Key Evidence == | == Key Evidence == | ||
add text here relating to key evidence with regards to any of the above headings<br> | add text here relating to key evidence with regards to any of the above headings<br> | ||
== Resources <br> | == Resources <br> == | ||
add appropriate resources here | add appropriate resources here | ||
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== Case Studies == | == Case Studies == | ||
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== References == | == References == | ||
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References will automatically be added here, see [[Adding References|adding references tutorial]]. | References will automatically be added here, see [[Adding References|adding references tutorial]]. | ||
<references /> | <references /> | ||
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Revision as of 18:00, 18 December 2009
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Clinically Relevant Anatomy
[edit | edit source]
De Quervain's tenosynovitis involves the abductor pollicis longus and the extensor pollicis brevis tendons. Both muscles and tendons extend the thumb backwards or move the thumb away from the palm, radial abduction. These tendons perform similar movement and run from the forearm to the thumb.
Mechanism of Injury / Pathological Process
[edit | edit source]
Usually caused by a new repetitive activity such as gardening, knitting, racket sports, or work tasks. In the technology age is has been nicknamed “Blackberry Thumb”1
Clinical Presentation[edit | edit source]
DeQuervains occurs in women 8-10 times more often than men.2 The condition can be sudden or gradual. Presents most commonly with pain and/or swelling on the radial side of the wrist at the base of the thumb (first dorsal compartment). Symptoms increase with pinching, grasping, and gripping activities. Pain at the thumb and wrist can progress up the forearm. New mothers are prone to this due to child care tasks with lifting, holding and feeding placing the hand in awkward positions; as well as hormonal changes.3
Diagnostic Procedures[edit | edit source]
Finkelstein test
Management / Interventions
[edit | edit source]
Non Operative:
Rest: activity modification and use of brace/splint for the thumb and wrist.
Anti-inflammatory: oral medication, phonophoresis, inotophoresis, or cold packs.
Injection: steroid
Surgery:
The sheath of the first dorsal compartment is opened longitudinally for decompression.
Differential Diagnosis
[edit | edit source]
1. Osteoarthritis of the first CMC joint1,4
2. Intersection syndrome – pain will be more towards the middle of the back of the forearm and about 2-3 inches below the wrist1,4
3. Wartenberg’s Syndrome - isolated neuritis of the superficial radial nerve, can be caused by tight jewelry1,4
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
