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 presents with the complaint of left wrist pain of 3 weeks duration. Pain is located at the base of her thumb and radiates proximally on the radial side of her forearm. Pain is described as sharp and is exacerbated by picking up her newborn baby or with making a fist and is improved with rest. Patient does not identify any injury. There is tenderness to palpation over the first dorsal compartment of the wrist at the level of the radial styloid. Wrist motion is normal. Eichhoff's test was positive. Type of Probe Used: 15-6 MHz linear array probe Labeled long axis unaffected hand A labeled long axis view of the contralateral (non-symptomatic) first dorsal extensor compartment of the wrist Short axis--Unaffected wrist An unlabeled short axis view of the contralateral (non-symptomatic) first dorsal extensor compartment of the wrist 1st extensor compartment of dorsal wrist (Long Axis) A labeled long axis view of the first dorsal extensor compartment of the wrist Short axis view of 1st extensor compartment of dorsal wrist A labeled short axis view of the first dorsal extensor compartment of the wrist Long axis 1st extensor compartment of dorsal wrist A long axis view of the first dorsal extensor compartment of the wrist Short Axis view of 1st extensor compartment of dorsal wrist (unlabeled) A short axis view of the first dorsal extensor compartment of the wrist. Interpretation Image Interpretation: Short Axis view of the first dorsal extensor compartment demonstrated a thickened, hypoechoic extensor retinaculum. There was evidence of tenosynovial fluid. Long axis view of the first extensor compartment demonstrates tenosynovial fluid within the first dorsal extensor compartment tendon sheath. Teaching Pearl: DeQuervain's tenosynovitis affects the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist at the styloid process of the radius. This is a common cause of wrist pain in adults and is most common in females between 30 and 50 years old. Pain is typically localized over the first dorsal compartment of the wrist and may radiate proximally. The provocative Eichhoff's test, in which the thumb is flexed and held inside a fist, with the patient actively deviates the wrist ulnarly, causes sharp pain along the radial wrist at the first dorsal compartment. Ultrasound findings may include: thickening of the APL and EPB tendons at the level of the radial styloid, increased fluid within the first extensor tendon compartment tendon sheath and/or thickening of overlying extensor retinaculum and synovial sheath. Increased flow on color doppler imaging may also be seen.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

Labeled long axis unaffected hand

Short axis--Unaffected wrist

1st extensor compartment of dorsal wrist (Long Axis)

Short axis view of 1st extensor compartment of dorsal wrist

Long axis 1st extensor compartment of dorsal wrist

Short Axis view of 1st extensor compartment of dorsal wrist (unlabeled)

Interpretation

UPCOMING EVENTS

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