De Quervain’s Tenosynovitis
Pathophysiology
De Quervain’s Tenosynovitis is an irritation of the outer layer of the tendon which controls thumb movements. Commonly affects young mothers, thought to be due to hormonal changes and repetitive lifting or can be a result of a direct blow to the area.
Symptoms
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Pain over the outside of the thumb, tender to press
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May have swelling of the tendon
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Pain on thumb movements
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Pain on resisted thumb movements
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Pain on gripping and lifting tasks
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May hear clicking or snapping of the tendon
Management
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Activity modification
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Ice or heat
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Pain relief
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Physiotherapy including range of movement, strengthening exercises and splinting
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Orthopaedic options include steroid injection or surgery if symptoms do not improve with conservative measures
Investigations
If symptoms do not settle with conservative management within 3 months steroid injection may be offered or if this fails surgery may be considered
