De Quervain syndrome

Not to be confused with De Quervain's thyroiditis.

de Quervain Syndrome
Other namesPotentially misleading names related to speculative causes: BlackBerry thumb, texting thumb, gamer's thumb, washerwoman's sprain, mother's wrist, mommy thumb, designer's thumb. Variations on eponymic or anatomical names: radial styloid tenosynovitis, de Quervain disease, de Quervain tendinopathy, de Quervain tenosynovitis.
The modified Eichoff maneuver, commonly referred to as the Finkelstein's test. The arrow mark indicates where the pain is worsened in de Quervain syndrome.[1][2]
Pronunciation
  • French pronunciation: [də kɛʁvɛ̃]
SpecialtyHand surgery, Plastic surgery, Orthopedic surgery.
SymptomsPain and tenderness on the thumb side of the wrist[3]
Usual onsetGradual[4]
Risk factorsRepetitive movements, trauma
Diagnostic methodBased on symptoms and examination[3]
Differential diagnosisBase of thumb Osteoarthritis[4]
TreatmentPain medications, splinting the wrist and thumb[4]

De Quervain syndrome occurs when two tendons that control movement of the thumb become constricted by their tendon sheath in the wrist.[3][5][6] This results in pain and tenderness on the thumb side of the wrist.[3] Radial abduction of the thumb is painful.[6] On some occasions, there is uneven movement or triggering of the thumb with radial abduction.[4] Symptoms can come on gradually or be noted suddenly.[4]

The diagnosis is generally based on symptoms and physical examination.[3] Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist.[4][6]

Treatment for de Quervain tenosynovitis focuses on reducing inflammation, restoring movement in the thumb, and maintaining the range of motion of the wrist, thumb, and fingers.[6] Symptomatic alleviation (palliative treatment) is provided mainly by splinting the thumb and wrist. Pain medications such as NSAIDs can also be considered.[4][6] Steroid injections are commonly used, but are not proved to alter the natural history of the condition.[7] Surgery to release the first dorsal component is an option.[4] It may be most common in middle age.[3]

  1. ^ Campbell, William Wesley; DeJong, Russell N. (2005). DeJong's the Neurologic Examination. Lippincott Williams & Wilkins. p. 583. ISBN 978-0-7817-2767-9.
  2. ^ Cite error: The named reference I2007 was invoked but never defined (see the help page).
  3. ^ a b c d e f "De Quervain's Tendinosis - Symptoms and Treatment - OrthoInfo - AAOS". December 2013. Retrieved 21 June 2018.
  4. ^ a b c d e f g h Hubbard, MJ; Hildebrand, BA; Battafarano, MM; Battafarano, DF (June 2018). "Common Soft Tissue Musculoskeletal Pain Disorders". Primary Care. 45 (2): 289–303. doi:10.1016/j.pop.2018.02.006. PMID 29759125. S2CID 46886582.
  5. ^ Satteson, Ellen; Tannan, Shruti C. (2022), "De Quervain Tenosynovitis", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28723034, retrieved 12 July 2022
  6. ^ a b c d e "De Quervain tenosynovitis". Mayo Clinic. 4 August 2022. Retrieved 27 August 2023.
  7. ^ Makarawung, D.; Becker, S.; Stijin, S.; Ring, D. (2013). "Disability and Pain after Cortisone versus Placebo Injection for Trapeziometacarpal Arthrosis and De Quervain Syndrome". American Association for Hand Surgery. 8 (4): 375–81. doi:10.1007/s11552-013-9529-2. PMC 3840768. PMID 24426952. S2CID 46298009.