De Quervian's tenosynovitis

De Quervain’s syndrome is stenosing tenosynovial inflammation of the 1st dorsal compartment. This impairs gliding of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons, can impair thumb function and causes pain on the radial (thumb) side of the wrist.

• Mechanism of onset, location of symptoms, severity and longevity of symptoms, limitation to function.

1. Range of wrist movement and general hand function
2. Palpate for pain and swelling over the distal radial styloid
3. Positive Finkelstein's Test (YouTube.com)
4. Resisted extension of the thumb.

None at this stage.

• OA base of thumb
• Radio carpal joint OA.

• Self-management for 8 weeks –
• Pain relief in line with agreed formularies/ guidance
• Patient information and isometric exercises - BSSH. De Quervain's syndrome
• NHS A&A De Quervain's tenosynovitis patient information.
• Activity modification and corticosteroid injection if available within practice and symptoms not resolving with the above conservative management within 6 wks
• Wrist and thumb splint

Diagnostically uncertain
Symptoms persist beyond 2-3/12 and/or interfere with ADLs
Exceptionally severe.