De Quervain's tenosynovitis: Causes, Signs, Diagnosis & Treatment - Dr. Yogishwar A V

De Quervain’s tensynovitis is a painful condition where there is an irritation of the tendons located at the base of the thumb. Mainly there are two tendons that get irritated, they are the abductor policis longus and extensor policis brevis. These tendons are covered with a sheath along with the first extensor compartment. The cause of the problem is due to over use of the wrist, especially the thumb and the wrist, maybe obesity, pregnancy, rheumatoid arthritis are other causes that can cause these symptoms. Patient presents with pain at the base of the thumb. There will be swelling at the base of the thumb and also you can hear a snapping when you try to move your thumb across your fingers, so these are the presenting symptoms. So how do you diagnose the symptom or the condition, this condition is diagnosed by presenting these compliant. So the doctor examines your thumb and your wrist and simple test which we need to do is we need to close the thumb and flex your fingers and try to move it ulnarwards. So when you do this you will get pain across this direction. So that is the most diagnostic test for this De Quervain’s tensynovitis. This is called as Finkelstein’s test. The treatment option are divided into two. One is the surgical option and other one is non-surgical option. 80 to 90% of the patients are treated non surgically by avoiding certain activities; like you can use a splint, splint the thumb in this direction, where the thumb is an extension and you can also use local ice remedy and non-steroidal anti-inflammatory and physical therapy helps in controlling the symptoms. Coming to the surgical intervention, when all these symptoms fail as the patient is not having any relief, then we do a mini open release of the first compartment or the extensor compartment and the compartments are free and these are the treatment for De Quervain’s tensynovitis.

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