De Quervain syndrome
De Quervain syndrome occurs when two tendons that control movement of the thumb become constricted by their tendon sheath in the wrist. This results in pain and tenderness on the thumb side of the wrist. Radial abduction of the thumb is painful. On some occasions, there is uneven movement or triggering of the thumb with radial abduction. Symptoms can come on gradually or be noted suddenly.
| de Quervain Syndrome | |
|---|---|
| Other names | Potentially misleading names related to speculative causes: BlackBerry thumb, texting thumb, gamer's thumb, washerwoman's sprain, mother's wrist, mommy thumb, designer's thumb. Variations on eponymic or anatomical names: radial styloid tenosynovitis, de Quervain disease, de Quervain tendinopathy, de Quervain tenosynovitis. |
| The modified Eichoff maneuver, commonly referred to as the Finkelstein's test. The arrow mark indicates where the pain is worsened in de Quervain syndrome. | |
| Pronunciation |
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| Specialty | Hand surgery, Plastic surgery, Orthopedic surgery. |
| Symptoms | Pain and tenderness on the thumb side of the wrist |
| Usual onset | Gradual |
| Risk factors | Repetitive movements, trauma |
| Diagnostic method | Based on symptoms and examination |
| Differential diagnosis | Base of thumb Osteoarthritis |
| Treatment | Pain medications, splinting the wrist and thumb |
The diagnosis is generally based on symptoms and physical examination. Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist.
Treatment for de Quervain tenosynovitis focuses on reducing inflammation, restoring movement in the thumb, and maintaining the range of motion of the wrist, thumb, and fingers. Symptomatic alleviation (palliative treatment) is provided mainly by splinting the thumb and wrist. Pain medications such as NSAIDs can also be considered. Steroid injections are commonly used, but are not proved to alter the natural history of the condition. Surgery to release the first dorsal component is an option. It may be most common in middle age.