De Quervain’s tenosynovitis is an inflammation of the tendon sheath of two wrist tendons: the abductor pollicis longus and the extensor pollicis brevis. These tendons run together through a narrow tunnel under the extensor retinaculum on the thumb side of the wrist.
Due to irritation or overuse, the tendon sheath can thicken, making the tunnel relatively too small and preventing the tendons from gliding smoothly. This causes pain on the thumb side of the wrist, especially when gripping or pinching.
The diagnosis is usually made based on the clinical examination. In cases of recurrent symptoms, an ultrasound may be performed to confirm the diagnosis and to plan a possible surgical procedure.
Non-surgical
The initial treatment consists of rest, anti-inflammatory medication, a thumb-wrist splint, and possibly a corticosteroid injection into the tendon sheath.
Surgical
If symptoms persist, a surgical procedure may be performed in which the first extensor compartment is opened so that the tendons can glide freely again.
After surgery, immobilization for about two weeks is usually recommended to promote proper wound healing. Afterward, gradual movement of the wrist and thumb can be resumed
