De Quervain’s stenosing tenosynovitis is a painful inflammation of the tendons of Extensor Policis Brevis (EPB) and Abductor Policis Longus (APL) which together make up the first dorsal compartment. (Figure 1) Symptoms develop when the tendons cannot glide because of thickening of the sheath of the first Dorsal compartment. It commonly affects patients between 30 to 50 years of age with a strong predilection for women. Repetitive motion of the wrist is a strong risk factor.
Clinical examination usually reveals tenderness just over the radial styloid. Finkelsteins test is pathongomic of DeQuervains tenosynovitis. (Figure 2)
In this test, the patient makes a fist with his/her thumb placed under his/her little finger, and ulnar deviates the wrist. The patients symptoms are strongly reproduced with this test.
Treatment for early symptoms include rest, activity modification and analgesia. Steroid injections are useful for cases which do not respond to conservative treatment.
Surgical release is recommended for recalcitrant cases.