De Quervain tenosynovitis is an entrapment tendinitis of the tendons contained within the first dorsal compartment at the wrist; it causes pain during thumb motion.

Symptoms of de Quervain's tenosynovitis include

  • Pain near the base of your thumb
  • Swelling near the base of your thumb
  • Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
  • A "sticking" or "stop-and-go" sensation in your thumb when moving it

dequervainIf the condition goes too long without treatment, the pain may spread further into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

Risk factors for de Quervain's tenosynovitis include

  • Age. If you're between the ages of 30 and 50, you have a higher risk of developing de Quervain's tenosynovitis than do other age groups, including children.
  • Sex. The condition is more common in women.
  • Being pregnant. The condition may be associated with pregnancy.
  • Baby care. Lifting your child repeatedly involves using your thumbs as leverage and may also be associated with the condition.
  • Jobs or hobbies that involve repetitive hand and wrist motions. These may contribute to de Quervain's tenosynovitis.

Diagnosis of de Quervain's tenosynovitis is based mainly on clinical examination. Your doctor will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist.
Your doctor will also perform a Finkelstein test, in which you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain's tenosynovitis.

Initial treatment of de Quervain's tenosynovitis may include

  • Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
  • Avoiding repetitive thumb movements as much as possible
  • Avoiding pinching with your thumb when moving your wrist from side to side
  • Applying ice to the affected area
  • Injection of corticosteroid into the sheath of the first dorsal compartment reduces tendon thickening and inflammation.

Surgical release of de Quervain tenosynovitis is an outpatient procedure. The operation can be performed under local or regional anaesthesia. Use of a tourniquet precludes intraoperative bleeding and facilitates the identification of structures.

Dequervain1