De Quervain's Tenosynovitis: Difference between revisions
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== Mechanism of Injury / Pathological Process<br> == | == 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> | 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><ref name="Wikipedia">Wikipedia. De Quervain syndrome. www.en.wikipedia.org/wiki/DeQuervain's_syndrome (accessed 13 Dec 2009)</ref></sup><br> | ||
== Clinical Presentation == | == Clinical Presentation == | ||
DeQuervains occurs in women 8-10 times more often than men. | DeQuervains occurs in women 8-10 times more often than men. <ref name="web MD">What is de Quervain's Disease? www.webmd.com/rheumatoid-arthritis/de-quervains-disease (accessed 15 Dec 2009)</ref>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. <ref name="hand">assh.org/Public/HandConditions/Pages/deQuervain'sTendonitis.aspx (accessed 13 Dec 2009)</ref> | ||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Finkelstein test <br>[http://en.wikipedia.org/wiki/File:Originaler_Finkelstein-Test.jpg#file en.wikipedia.org/wiki/File:Originaler_Finkelstein-Test.jpg#file] | Finkelstein test <br>[http://en.wikipedia.org/wiki/File:Originaler_Finkelstein-Test.jpg#file en.wikipedia.org/wiki/File:Originaler_Finkelstein-Test.jpg#file] | ||
== Management / Interventions<ref name="Wheeless" /><br> == | == Management / Interventions<ref name="Wheeless" /><br> == | ||
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== Differential Diagnosis<br> == | == Differential Diagnosis<br> == | ||
1. Osteoarthritis of the first CMC joint<sup> | 1. Osteoarthritis of the first CMC joint<sup><ref name="Wikipedia" /><ref name="Wheeless">DeQuervain's Disease - Wheeless' Textbook of Orthopaedics www.wheelssonline.com/ortho/dequervains_disease (accessed 13 Dec 2009)</ref></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><ref name="Wikipedia" /><ref name="Wheeless" /></sup><br>3. Wartenberg’s Syndrome - isolated neuritis of the superficial radial nerve, can be caused by tight jewelry<sup><ref name="Wikipedia" /><ref name="Wheeless" /></sup><br><br> | ||
== Key Evidence == | == Key Evidence == | ||
Revision as of 18:45, 18 December 2009
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Clinically Relevant Anatomy
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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
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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
en.wikipedia.org/wiki/File:Originaler_Finkelstein-Test.jpg#file
Management / Interventions[4]
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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
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1. Osteoarthritis of the first CMC joint[1][4]
2. Intersection syndrome – pain will be more towards the middle of the back of the forearm and about 2-3 inches below the wrist[1][4]
3. Wartenberg’s Syndrome - isolated neuritis of the superficial radial nerve, can be caused by tight jewelry[1][4]
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
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add appropriate resources here
Case Studies[edit | edit source]
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References[edit | edit source]
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- ↑ 1.0 1.1 1.2 1.3 Wikipedia. De Quervain syndrome. www.en.wikipedia.org/wiki/DeQuervain's_syndrome (accessed 13 Dec 2009)
- ↑ What is de Quervain's Disease? www.webmd.com/rheumatoid-arthritis/de-quervains-disease (accessed 15 Dec 2009)
- ↑ assh.org/Public/HandConditions/Pages/deQuervain'sTendonitis.aspx (accessed 13 Dec 2009)
- ↑ 4.0 4.1 4.2 4.3 DeQuervain's Disease - Wheeless' Textbook of Orthopaedics www.wheelssonline.com/ortho/dequervains_disease (accessed 13 Dec 2009)
