De Quervain’s Disease

It is a painful condition of wrist.Pain is at the lower end of the wrist at the root of the thumb.Wrist movements become painful  particularly when rotation with fore is required eg. Opening & closing of a water tap or squeezing or wringing of clothes.

There may be swelling at the lower end of radius which is painful to touch.

Some times it appears during third trimester of pregnancy , but settles down of its own after delivery.

De Quervain’s stenosing tenosynovitis affects the tendon sheath of

abductor pollicis longus and extensor pollicis brevis at the radial

styloid process.  

 Tenderness & swelling  at the wrist are suggestive, but Finkelstein’s test   diagnostic. ( Ask the patient to close wrist with thumb in palm,give a sudden ulner jerk to the wrist,patient stands up with pain)

  Crepitus or a tendon nodulemay cause triggering.

Management   — Rest is essential, with avoidance

of thumb extension and pinching. Immobilization splints help, but are

are inconvenient.

Anti inflamatory drugs along with antioxidents gives relief.

Physiotherapy including wax bath, US. IFT & remideal exercises help.

Injection of steroid with local anesthetic give immidiate relief.It is better avoided,as the long term effects of steroids are not desirable.

Rarely surgical release of the tendons may have to under taken.