De Quervain Tenosynovitis

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De Quervain Tenosynovitis

Authors, Editors, Case Information Author: Kyle Samyn, DO, MS Affiliation: Ascension Providence Sports Medicine Fellowship Co Author(s): Nicholas Moore, MD Navin Abro, DO Clinical Vignette: A 30-year-old left hand dominant female presented with 3 weeks of left wrist pain located at the base of her thumb and radiating proximally on the radial side of her forearm. Pain was described as sharp and was exacerbated by picking up her newborn baby or with making a fist and was improved with rest. She denied known injury. There was tenderness to palpation over the first dorsal compartment of the wrist at the level of the radial styloid. Wrist range of motion was normal. Eichhoff's test was positive. Type of Probe Used: 15-6 MHz linear array transducer Unlabeled Short Axis View of the Left Wrist 1st Dorsal Compartment Unlabeled Short Axis View of the Left (Injured) Wrist 1st Dorsal Compartment Labeled Short Axis View of the Left (Injured) Wrist 1st Dorsal Compartment Labeled Short Axis View of the Left (Injured) Wrist 1st Dorsal Compartment with a thickened, hypoechoic extensor retinaculum, and evidence of tenosynovial fluid. Unlabeled Long Axis View of the Left Wrist 1st Dorsal Compartment Unlabeled Long Axis View of the Left (Injured) Wrist 1st Dorsal Compartment Labeled Long Axis View of the Left (Injured) Wrist 1st Dorsal Compartment Labeled Long Axis View of the Left (Injured) Wrist 1st Dorsal Compartment with tenosynovial fluid within the tendon sheath. Labeled Long Axis View of the Right (Uninjured) Wrist 1st Dorsal Compartment Labeled Long Axis View of the Right (Uninjured) Wrist 1st Dorsal Compartment for contralateral comparison with normal appearance Interpretation Image Interpretation: First dorsal extensor compartment (abductor pollicis longus and extensor pollicis brevis) with a thickened, hypoechoic extensor retinaculum and evidence of tenosynovial fluid consistent with De Quervain Tenosynovitis. Teaching Pearl: De Quervain tenosynovitis affects the abductor pollicis longus and extensor pollicis brevis in the first dorsal extensor compartment at the radial styloid. Ultrasound may show retinacular thickening, tendon sheath fluid, synovial hypertrophy, Doppler hyperemia, and impaired tendon gliding. It can also be beneficial to look for a septated first compartment or separate EPB subcompartment, because this can explain incomplete response to injection if medication does not reach both tendon compartments. Ultrasound can also help to distinguish De Quervain disease from alternative causes of radial-sided dorsal wrist pain such as intersection syndrome, thumb CMC arthritis, a symptomatic ganglion, or superficial radial neuritis. References: 1. Lee KH, Kang CN, Lee BG, Jung WS, Kim DY, Lee CH. Ultrasonographic evaluation of the first extensor compartment of the wrist in de Quervain’s disease. J Orthop Sci. 2014;19(1):49-54. doi:10.1007/s00776-013-0481-3 2. De Keating-Hart E, Touchais S, Kerjean Y, Ardouin L, Le Goff B. Presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in de Quervain’s syndrome. J Hand Surg Eur Vol. 2016;41(2):212-219. doi:10.1177/1753193415611414 3. Lee YS, Choi WS, Baek SH, Kang H, Lee CH. Comparative analysis of ultrasound and surgical findings in anatomical variations of de Quervain’s disease. Clin Orthop Surg. 2025;17(2):308-316. doi:10.4055/cios24127
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Authors, Editors, Case Information

Unlabeled Short Axis View of the Left Wrist 1st Dorsal Compartment

Labeled Short Axis View of the Left (Injured) Wrist 1st Dorsal Compartment

Unlabeled Long Axis View of the Left Wrist 1st Dorsal Compartment

Labeled Long Axis View of the Left (Injured) Wrist 1st Dorsal Compartment

Labeled Long Axis View of the Right (Uninjured) Wrist 1st Dorsal Compartment

Interpretation

UPCOMING EVENTS

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