II. Pathophysiology
- Inflammation of thumb extensor tendons
- Extensor pollicis brevis
- Abductor pollicis longus
- Occurs where tendons cross radial styloid
III. Variations: Extensor Carpi Radialis Tenosynovitis
- Affects radial wrist extensors
- Seen in heavy laborers
- Same signs, symptoms and management as de Quervain's
IV. Signs and symptoms
- First dorsal extensor compartment (snuff box) symptoms
- Crepitation with extensor tendon movement
- Local thickening of tendon sheath
- Radiation of pain
- Ascending up Forearm
- Descending down into thumb
- Provocative maneuver eliciting pain
- Finkelstein Test
- Active and passive range of motion of thumb
V. Differential Diagnosis
- See Wrist Pain
- Ganglion Cyst
- Radial Nerve entrapment at Forearm
- Wrist extensor Tendinopathy
-
Osteoarthritis
- First extensor compartment
- First Metacarpophalangeal joint Osteoarthritis
VI. Management
- NSAIDs
- Immobilization
- Avoid offending activity
- Moist heat as needed
- De Quervain's Tenosynovitis Injection
- Surgical correction: first dorsal compartment release
- Indicated for persistent symptoms despite above