De Quervain tenosynovitis is an inflammation of the sheath that surrounds the tendons of the extensor pollicis brevis and abductor pollicis longus.
One of the tendons that gets inflamed in De Quervain Tenosynovitis is one from the extensor pollicis brevis.
The other tendon involved in the pathophysiology of De Quervain Tenosynovitis is the one from the abductor pollicis longus.
The inflammation of the sheath occurs when the abductor pollicis longus and extensor pollicis brevis tendons pass through the styloid process of the radius.
As the tendons get inflamed, and this process progresses, the tendons get progressively compressed, causing pain.
As stenosis progresses, the compression of the tendons causes progressive and increasing pain in the styloid process of the radius that may radiate to the thumb or elbow.
In De Quervain Tenosynovitis, movement, as well as grasping of objects, increases pain.
There are some groups with a higher propensity to develop this disease. New mothers are at risk of this disease.
Tennis players and golfers are also at increased risk of developing this disease.
Thumb texters are also at risk of developing De Quervain Tenosynovitis.
Diagnosis of De Quervain Tenosynovitis is clinical. The examination involves the Finkelstein maneuver, which consists of asking the patient to hold the thumb in a fist while the examiner performs an ulnar deviation, eliciting pain.
Initial treatment is conservative: it consists of NSAIDs and other analgesics, physical therapy, splintage, and steroid injections.
If conservative therapy fails, surgery can be performed. This surgery involves the surgical release of the tendons through an incision in the extensor retinaculum.
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