II. Epidemiology

  1. Most common in women 30 to 50 years old
  2. Also more common at 4 to 6 weeks postpartum

III. History

  1. First described by the swiss surgeon Fritz de Quervain in 1895

IV. Pathophysiology

  1. Tendon Entrapment and inflammation of the thumb extensor tendons
    1. Extensor pollicis brevis tendon
    2. Abductor pollicis longus tendon
  2. Occurs where tendons cross radial styloid
    1. First dorsal extensor compartment of the radial wrist
    2. Associated with overuse with repetitive wrist or thumb movement
  3. Variations: Extensor Carpi Radialis Tenosynovitis
    1. Affects radial wrist extensors
    2. Seen in heavy laborers
    3. Same signs, symptoms and management as de Quervain's

V. Risk Factors

  1. Pregnancy
  2. Repetitive motion of the thumb and wrist (e.g. hammering, knitting)
  3. Heavy lifting
  4. Rheumatoid Arthritis
  5. Diabetes Mellitus

VI. Findings: Signs and symptoms

  1. Tenderness and swelling at the radial wrist (thumb base or radial styloid)
    1. First dorsal extensor compartment (snuff box) symptoms
    2. Crepitation with extensor tendon movement
    3. Local thickening of tendon sheath
  2. Radiation of pain
    1. Ascending up Forearm
    2. Descending down into thumb
  3. Provocative maneuver eliciting pain
    1. Finkelstein Test
    2. Active and passive range of motion of thumb

VII. Differential Diagnosis

  1. See Wrist Pain
  2. Ganglion Cyst
  3. Radial Nerve entrapment at Forearm
  4. Wrist extensor Tendinopathy
  5. Osteoarthritis
    1. First extensor compartment
    2. First Metacarpophalangeal joint Osteoarthritis

VIII. Management

  1. NSAIDs
  2. Thumb spica spint immobilization
  3. Avoid offending repetitive activity
  4. Moist heat as needed
  5. De Quervain's Tenosynovitis Injection
  6. Surgical correction: first dorsal compartment release
    1. Indicated for persistent symptoms despite above

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Related Studies

Ontology: Tendon Entrapment (C0158329)

Definition (MSH) Narrowing or stenosis of a tendon's retinacular sheath. It occurs most often in the hand or wrist but can also be found in the foot or ankle. The most common types are DE QUERVAIN DISEASE and TRIGGER FINGER DISORDER.
Concepts Disease or Syndrome (T047)
MSH D053682
SnomedCT 66452006
English Entrapment, Tendon, Entrapments, Tendon, Stenosing Tendovaginitides, Stenosing Tendovaginitis, Stenosing Tenosynovitides, Stenosing Tenosynovitis, Stenosing Tenovaginitides, Stenosing Tenovaginitis, Tendon Entrapments, Tendon Entrapment, Tendovaginitides, Stenosing, Tendovaginitis, Stenosing, Tenosynovitides, Stenosing, Tenosynovitis, Stenosing, Tenovaginitides, Stenosing, Tenovaginitis, Stenosing, Tendon Entrapment [Disease/Finding], stenosing tenosynovitis, Constrictive tenosynovitis, Stenosing tenosynovitis, Stenosing tenosynovitis (disorder)
Portuguese Tenossinovite Estenosante, Tendovaginite Estenosante, Encarceramento do Tendão
Spanish Atrapamiento del Tendón, Tendosinovitis Estenosante, Tendovaginitis Estenosante, Atrapamiento Tendinoso, tenosinovitis constrictiva, tenosinovitis estenosante (trastorno), tenosinovitis estenosante
Russian СТЕНОЗИРУЮЩИЙ ТЕНДОВАГИНИТ, СТЕНОЗИРУЮЩИЙ ТЕНДОСИНОВИТ, ТЕНДОВАГИНИТ СТЕНОЗИРУЮЩИЙ, СУХОЖИЛИЯ УЩЕМЛЕНИЕ, ТЕНДОСИНОВИТ СТЕНОЗИРУЮЩИЙ, STENOZIRUIUSHCHII TENDOSINOVIT, TENDOSINOVIT STENOZIRUIUSHCHII, TENDOVAGINIT STENOZIRUIUSHCHII, STENOZIRUIUSHCHII TENDOVAGINIT, SUKHOZHILIIA USHCHEMLENIE
Italian Stenosi del tendine, Tenovaginite stenosante, Tenosinovite stenosante, Tendovaginite stenosante
German Sehnenengpass, Tenosynovitis, stenosierende, Tendovaginitis, stenosierende, Stenosierende Tendovaginitis, Tenovaginitis, stenosierende, Stenosierende Tenosynovitis
French Ténosynovite sténosante
Finnish Jännepinne
Czech stenózující tendovaginitida, stenózující tenosynovitida, úžinový syndrom
Japanese 狭窄性腱鞘炎, 腱滑膜炎-狭窄性, 狭窄性腱滑膜炎, 腱鞘炎-狭窄性
Swedish Stenoserande tenosynovit
Polish Zapalenie pochewki ścięgna zwężające, Zwężające zapalenie pochewki ścięgna
Norwegian Stenoserende tenosynovitt, Sene entrapment

Ontology: de Quervain syndrome (C2349401)

Concepts Disease or Syndrome (T047)
ICD10 E34.51
English de Quervain's syndrome, de Quervain syndrome