2. • In 1895, a Swiss surgeon, Fritz de
Quervain, published 5 case reports
of patients with a
tender, thickened first dorsal
compartment at the wrist. The
condition has subsequently borne
his name, De Quervain
tenosynovitis.
• (Medscape, 2013)
What is DeQuervains Tenosynovitis?
3. • De Quervain's Tenosynovitis occurs when tendons on the thumb
side of the wrist are swollen or irritated. The irritation causes the
lining (synovium) around the tendon to swell, which changes the
shape of the compartment. De Quervain tenosynovitis is an
entrapment tendinitis of the tendons contained within the first
dorsal compartment at the wrist; it causes pain during thumb
motion.
• DeQuervains Tenosynovitis may be caused by overuse. It can be
seen in association with pregnancy. It may be found in
inflammatory arthritis, such as rheumatoid disease. This condition
is usually most common in middle-aged women.
• (American Academy of Orthopedic Surgeons, 2013)
Causes of DeQuervains Tenosynovitis
4. Frequency Mortality/Morbidity Race Sex Age
Most prevalent
among
individuals
who perform
repetitive
activities using
their hands. For
example, certai
n assembly line
workers and
secretaries
Mortality is not
associated with de
Quervain
tenosynovitis. Some
morbidity may result
as the patient
experiences
progressive
pain, with limitations
occurring in activities
requiring use of the
affected hand.
No race
predilection
has been
reported for
de Quervain
tenosynovitis
The incidence
of de Quervain
tenosynovitis
appears to be
significantly
greater in
women
8:1 ratio
Seen in Adults
more than
children.
However as
discussed in
lecture, these
conditions are
increasing in
younger
populations.
• (Medscape, 2013)
Epidemiology
6. • 1Instruct the patient to sit on an examination table or in an elevated chair.
He or she should be as comfortable and relaxed as possible.
• 2Have the patient hold the afflicted hand in the air. The other arm should
be resting against his or her body.
• 3Grasp the patient's hand and rotate it toward the outside of the forearm,
a position known as ulnar deviation. The wrist won't move very much, so
don't force it beyond 20 degrees of flexion.
• 4Pull the patient's thumb across the palm of his or her hand. This places
tension on the extensor tendons of the thumb.
• 5Ask the patient if he or she feels pain radiating up the inside of his or her
arm from the thumb. If the patient reports noticeable pain, the
Finkelstein's Test is positive, and De Quervain syndrome is present
(eHow, 2013)
Instructions on how to perform the
Finkelstein Test
8. • Excellent. The patient can
generally return to full function
after the inflammation quiets
down with treatment.
Sometimes bracing is used
during future activities that
involve repetitive wrist motion.
What is the outlook (prognosis) with De
Quervain's tenosynovitis?
9. • American Academy of Orthopedic Surgeons (2013). DeQuervains
tenosynovitis. Retrieved on October 2, 2013 from
http://orthoinfo.aaos.org/topic.cfm?topic=a00007
• Medscape. (2013). DeQuervains tenosynovitis. Retrieved on October 2,
2013 from http://emedicine.medscape.com/article/1243387-overview
• The Pain Source (2011, December 15). Finkelstein’s test.*YouTube video+.
Retrieved on October 2, 2013 from
http://www.youtube.com/watch?v=eL2Uzfd26SA
• eHow.(2013). How to perform finkelstein’s test of the hand. Retrieved
October 2, 2013 fromhttp://www.ehow.com/how_2212413_perform-
finkelsteins-test-hand.html#ixzz2gcMtg9oG
References
