Understanding De Quervain's Tenosynovitis: Causes, Symptoms, and Management

What is it?

De Quervain's Tenosynovitis is a condition in which the tendons around the thumb are irritated or constricted, causing pain and tenderness. The pain worsens when forming a fist, grasping or gripping an object, or while turning the wrist. The thumb tendons, covered by their synovium, pass through some pulleys. When the tendons get swollen or the sheath gets thickened, the friction is increased, causing pain in different movements of these tendons. De Quervain's Tenosynovitis is most common in middle-aged women. Although the reason for this condition is not fully known, it can be caused by overuse, and may be associated with pregnancy or rheumatoid disease.

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Signs & symptoms

Symptoms of De Quervain's Tenosynovitis may include pain over the thumb, a gradual or sudden one. The pain can travel even up to the wrist and gets worse in movements that include the thumb such as grasping and twisting the wrist. It is possible to notice swelling over the thumb, which may accompany a fluid-filled cyst. While moving the thumb, a snapping sensation may be felt.

Diagnosis

De Quervain's Tenosynovitis is diagnosed in a physical examination, performing the Finkelstein test in which the patient’s thumb is placed against the hand while closing the fingers over the thumb to a fist and then bending the wrist toward the little finger. If it is painful, the test is positive for De Quevrain’s.

Treatment

Treatment may include a splint, anti-inflammatory medication (NSAIDs), painful activities avoidance and corticosteroid injection. A surgical treatment may be considered if other treatments fail. During surgery, the tendon’s sheath is cut, making more room for the tendons and reducing the friction.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital