De Quervain's Tenosynvitis
De Quervain’s tenosynvitis refers to painful condition involving the extensor tendons of the thumb as they cross the wrist. The pain is caused by inflammation of the extensor tendon and synovial chief that makes it very uncomfortable with motion of the wrist and thumb. There can be pain when making a fist, swelling on the thumb side of the wrist, the feeling of tightness as the tendon travels through the tendon sheath, and resulting decreased grip strength.
Another common moniker for this condition is “mommies thumb” because new mothers engaging in childcare often suffer with this condition. De Quervain’s tenosynovit is also more common than found in women. There are several theorized causes for this condition include repetitive motion of the thumb or wrist, direct injury to the tendon with scar tissue that forms to restrict motion, and inflammatory arthritis.
The Finkelstein test is a highly sensitive clinical maneuver used to diagnose this condition. A positive Finkelstein test results in pain at the base of the thumb, when bending the thumb across the palm and on early deviating the wrist. This pain is a result of stress on the extensor tendon and synovial sheath.
As with many conditions related information, anti-inflammatory therapy is the mainstay of non-operative treatment. This may include orally ingested or injected anti-inflammatory medication. Additionally in mobilization in a removable or non-removable splinter cast may also improve symptoms. Surgery involves releasing the affected tendons from surrounding restricted tissue and debridement of inflamed synovitis.