De Quervain's Tenosynovitis
De Quervain’s syndrome is stenosing tenosynovial inflammation of the 1st dorsal compartment. This impairs gliding of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons and thumb function, and causes pain on the radial (thumb) side of the wrist.
History; Patients suffering from De Quervain's syndrome experience pain and tenderness at the base of the thumb area near the first extensor compartment. Movement of the thumb and/or the wrist can provoke the pain. The pain may appear suddenly or may increase over time. Often, there is swelling over the first extensor compartment. Its prevalence is 0.5% for men and 1.3% for women among adults of working age in the general population. It is also common in new mothers.
Pain and/or weakness on resisted thumb abduction and/or extension +ve Finkelstein's test - grasps the thumb and ulnar deviate the wrist sharply. Positive response; sharp pain occurs along the distal radius.
Pain on palpation of APL and EPB tendons. Swelling on the lateral aspect of the wrist. Crepitus on the lateral aspect of the wrist on thumb movement.