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 for 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.
Sometimes it appears during third trimester of pregnancy, but settles down on its own after delivery.
De Quervain's stenosingtenosynovitis 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 diagnosis is important to be checked. ( 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 nodule may cause triggering.
Management — Rest is essential, with avoidance of thumb extension and pinching. Immobilization splints help, but are inconvenient.
Anti-inflammatory drugs along with antioxidants give relief.
Physiotherapy including wax bath, US. IFT & remedial exercises help.
Injection of steroid with localanesthetic gives immediate relief. It is better avoided, as the long term effects of steroids are not desirable.
Rarely surgical release of the tendons is done.