De Quervains Syndrome

Also Know As Radial Styloid Tenosynovitis

DeQuervain's syndrome

De Quervain Syndrome is a painful medical condition typified by entrapment tendinitis of the tendons on the thumb side of the wrist. Patients often experience pain when moving the thumb. Sometimes, the pain may even extend into the lower arm. ^{[1][2] [3]}

Epidemiology

Virtually anyone can be affected however the disorder is more common among females than males. ^[3]

Causes

The cause is often undetermined. Certain factors are implicated to cause the syndrome including overuse of the thumb, trauma and repetitive grasping. Some diseases like rheumatoid arthritis are thought to trigger the ailment. ^[3]

Women who recently had childbirth often have the condition 1 month to 6 weeks after delivery. Hormonal changes are considered to be a plausible reason. ^[1] Some suggest that repetitive lifting of the infant may predispose the condition. Thus, day care workers whose work requires lifting children also commonly experience it. ^[2]

Signs and Symptoms

The typical symptom is pain along the back of the thumb which can have sudden onset or can occur in a gradual fashion. Moving the thumb is painful especially during pinching and grasping actions. Some patients may notice signs of inflammation on the side of the wrist at the base of the thumb such as swelling and pain. Affected people may observe the pain to be aggravated by thumb and wrist movements. ^[3]

Diagnosis

After getting the medical history of the patient, the physician often performs a physical exam which usually includes Finkelstein test with sharp pain as the positive result. ^[3] Imaging studies are not necessary to routinely diagnose De Quervain Syndrome but radiographs may be significant to be able to rule out other conditions that can mimic the condition such as osteoarthritis. ^[2]         

Treatment

Treatment frequently involves the use of a splint in a span of 4 to 6 weeks for immobilization and for prevention of further complication. To lessen the degree of inflammation, ice may be applied on the area or anti-inflammatory drugs may be prescribed. If these measures fail, surgery may be done which is often done on an outpatient basis. ^[3]

 
References:  

1.      http://www.assh.org/Public/HandConditions/Pages/deQuervainsTendonitis.aspx

2.      http://emedicine.medscape.com/article/1243387-overview#a0103

3.      http://www.webmd.com/rheumatoid-arthritis/de-quervains-disease

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