DeQuervain's syndrome

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DeQuervain's syndrome (also known as washerwoman's sprain, Radial styloid tenosynovitis or De Quervain's disease), named for Swiss surgeon Fritz de Quervain who first identified it in 1885, is an inflammation of the sheath or tunnel that surrounds two tendons that control movement of the thumb.

It should not be confused with "De Quervain Thyroiditis" (E[061]).

Contents

1 Causes
2 Symptoms
3 Treatment
4 External links

Causes

It is caused by the repetitive motion of the thumb constantly being required to move up and down (usually associated with using a computer keyboard or typewriter). It can be included in a loose group of conditions called repetitive strain injuries.

Symptoms

Symptoms are pain and swelling over the thumb side of the wrist, possibly numbness on the back of the thumb, and difficulty gripping.

Finkelstein's test is used to diagnose DeQuervain's syndrome in people who have wrist pain. To perform the test, the thumb is placed in the closed fist and the hand is tilted towards the little finger, as shown in the image. If pain occurs at the wrist below the thumb, DeQuervain's tenosynovitis is likely.

Treatment

Management of DeQuervain's disease involves (1) discontinuing or modifying the precipitating motions and (2) reducing the inflammation. Given the irritability of the tendons, short term splinting of the thumb via a thumb spica is often required to prevent reaggravation with activities of daily living. Frequent and localized icing for short periods of time throughout the day, will reduce the inflammation. There is no peer reviewed objective evidence to support that any electromodality such as ultrasound or other passive treatment (accupuncture) will accelerate treatment. If there is no change in pain with splinting and icing, anti-inflammatory cream or cortisone may be considered as an option by your physician.

External links

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