Tenosynovitis

DE QUERVAIN’s TENOSYNOVITIS

The disease is associated with the inflammation of the tendons of two muscles which have synergistic action of extending the thumb. Victim is unable to clench his fist or move the thumb repeatedly as in playing music, lifting objects or doing so would result in pain and discomfort.

CAUSES: Inflammation of the tendon results because of the overuse of the muscles associated with the tendons which in this case are extensor pollicis brevis and adbuctor pollicis longus muscles. Direct physical trauma to the outer side of the wrist at the base of the thumb might initiate the inflammation. Also in rheumatoid arthritis, a disease of joints could be the cause. The condition is still to be researched on as the cause of the disease seems much more complex.

SYMPTOMS: While the patient grips something, the outer side of the wrist pains over the side of the thumb. The area becomes tender and swollen due to underlying inflammation of the two tendons. A fluid filled cavity might appear and a feeling of friction in the tendons might be felt.

TESTS: The specific condition is diagnosed by performing a physical method called as Finkelstein’s test. In this test, the doctor asks the patient to deviate his hand opposite to the thumb and grasps his thumb in the direction of the deviation, if the pain radiates in the same direction, the patient is suffering from the disease. The condition should be differentiated from intersection syndrome in which the pain radiates towards the back of the arm and hand.

TREATMENT: The treatment involves both drug administration and physical manipulation. Anti-inflammatory drugs and cortisone are mostly prescribed. Physical manipulation includes rest, splinting ice, immobilization of the wrist and even surgical approach in extreme cases.