DeQuervain/s Tenosynovitis

Question 1

What is the cause of DeQuervain’s Tenosynovitis

Answer 1

1. Cumulative disorder caused by overuse/repetitive movements of hand/wrist
   *will be inflammation fo the thumbs extensor tendons
   *Extensor pollicis brevis
   *Abductor pollicis longus

Question 2

Where does DeQuervain’s Tenosynovitis occur

Answer 2

Where the tendons cross the radial styloid
*tendon pass beneath the retinaculum and are surrounded by Tenosynovium

Question 3

What are the risk factors of DeQuervain’s Tenosynovitis

Answer 3

1. Employment
2. Diabetes
3. Inflammatory arthritis
4. Pregnancy

Question 4

What will be the presentation on PE?

Answer 4

1. Radial wrist pain/burning
2. May complain of popping and weakness
3. Finkelstein Test (fist with thumb inside and ulnar deviation)
4. First extensor compartment tenderness
5. Thickening of tendon sheath
6. Pain with resistance to thumb extension

Question 5

What are the diagnostic findings?

Answer 5

Radiographs: maybe calcification
MRI: only if they failed conservative treatment

Question 6

What are some of the complications?

Answer 6

1. Can progress to tendinopathy or rupture
2. Injection can cause risk discoloration, atrophy, tendon rupture, or elevated blood sugars

Question 7

What is the treatment of DeQuervains Tenosnovitis

Answer 7

1. NSAIDs
2. Immobilization (thumb spica removable splint)
3. Avoid offending activity
4. Therapy
5. Injection

Question 8

What is the injection technique for DeQuervains Tenosnovitis

Answer 8

1. Abduct thumb and Inject between the tendons, towards the distal radial styloid
2. Use a numbing agent plus cortisone
   *splint after injection

Question 9

What is the incorrect way to complete the injection technique

Answer 9

1. DO NOT inject directly into the tendon
2. Do not inject if paresthesias present with needle insertion, redirect