‘The side of my wrist hurts’: De Quervain’s tenosynovitis

Allbrook, Victoria

doi:10.31128/ajgp-07-19-5018

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…DQT causes pain and loss of function in the carpometacarpal joint. [ 24 ] Splinting is important in protecting the joint and, minimizing or eliminating stress in the joint during daily life activities. [ 25 ] In a few studies in the literature on the use of isolated forearm-based thumb splints, the results were not successful.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of corticosteroid injection and splint in diabetic de Quervain's tenosynovitis patients

et al. 2021

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Background: There is no clear information on the efficacy of corticosteroids, and splints in the treatment of patients with diabetes mellitus (DM). The aim of this study was to compare the outcomes of isolated corticosteroid injection therapy with splint treatment with corticosteroid injection in patients with and without DM. Methods: 84 diabetics, and 84 healthy patients with a diagnosis of de Quervain's tenosynovitis were included in our study. The patients were randomly distributed into four subgroups with and without DM. Groups 1 and group 2 consisted of diabetic patients, while group 3 and group 4 consisted of healthy patients. Corticosteroid injections were administered to groups 1 and 3, and corticosteroid injection and splint treatment were administered to groups 2 and 4. Results: There was no significant difference in terms of age, gender, dominant/non-dominant hand, pre-treatment Quick Disabilities of the Arm, Shoulder and Hand score and visual analog scale scores score between the four groups. Quick Disabilities of the Arm, Shoulder and Hand and visual analog scale scores in the four groups were found to be significantly better than pre-treatment at the 12th month. Finkelstein test results were positive in 37.5% of the patients in the first group, 35% of the patients in the second group, 20% of the patients in the third group and 9.5% of the patients in the fourth group. Groups 1 and 2 and, groups 3 and 4 were compared to evaluate the effect of the splint. While forearm-based thumb splint affected the results positively in healthy individuals, it was determined that it had no effect on the results in diabetic patients. Conclusion: Although corticosteroid treatment is effective in the treatment of de Quervain's tenosynovitis in healthy and diabetic individuals, the results are worse in diabetic patients than in healthy patients. In addition, the use of splint with corticosteroid injection in healthy individuals positively affects the results, while it does not affect the results in diabetic patients.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of corticosteroid injection and splint in diabetic de Quervain's tenosynovitis patients

et al. 2021

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“…The choice of preferred treatment for de Quervain's tenosynovitis is subject to the severity of the condition, however non-surgical treatment with anti-inflammatory drugs, immobilization and recovery is preferred (10,11).…”

Section: Developmentmentioning

confidence: 99%

“…The existence of a septum and tendon movements contribute to the failure of non-surgical treatment. Surgical techniques require decompression of the first dorsal compartment, with reconstruction of the compartment if necessary to prevent possible tendon subluxation (11,16).…”

Section: Developmentmentioning

confidence: 99%

Quervain's Tenosynovitis, General Description

García¹,

Patiño²,

García³

et al. 2022

EPRA

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INTRODUCTION: Quervains tenosynovitis is a condition involving tendon entrapment affecting the first dorsal compartment of the wrist, causing pain that increases with thumb movement and radial and ulnar deviation of the wrist. OBJECTIVE: To detail the current information related to Quervains tenosynovitis and its management, as well as to analyze the conservative and surgical treatment of this disease. METHODOLOGY: A total of 28 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 18 bibliographies were used because the other 10 articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Elsevier; the terms used to search for information in Spanish and English were: Quervains Tenosynovitis, surgical quervains tenosynovitis. corticosteroids and quervain, non-surgical treatment tenosynovitis. RESULTS: The choice of preferred treatment is subject to the severity of the condition. Oral non-steroidal anti-inflammatory drugs accompanied by immobilization are a good option. Corticosteroid injections are effective for this tenosynovitis, leading to success 73.4% of the time with 2 injections. The use of ultrasound can improve the accuracy of the injections. Surgery is essential in cases that recur and are not relieved by conservative therapies over the course of 3 to 6 months. CONCLUSIONS: De Quervains tenosynovitis is a pathology based on inflammation of the tendon sheath of the abductor pollicis longus and extensor pollicis brevis in the first extensor compartment of the wrist. Its diagnosis is clinical with a positive Finkelsteins test. Non-surgical measures are preferred for its treatment. The use of splints and corticosteroid injections together provides more benefit than when used individually. And finally surgical treatment is effective and safe but is not without complications. KEY WORDS: Tenosynovitis, Quervains, inflammation

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“…In those patients that conservative treatment fails, surgical treatment can be recommended. The procedure involves releasing the first dorsal compartment in-line with the thumb extensor tendons within the first dorsal compartment [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Clinical Implications and Treatment Algorithm for Patients with de Quervain’s Tenosynovitis

Pearson¹

2022

GJOR

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Purpose: De Quervain's tenosynovitis can be a debilitating condition affecting the first dorsal compartment of the wrist. Depending on the severity, patients experiencing this pathology often lose significant functionality in the affected wrist. Upon diagnosis, non-surgical treatment is the standard of care, but failure of conservative treatments can lead to the need for surgical intervention. The main purpose of this study was to report the clinical implications and treatment algorithm for patients presenting with de Quervain's tenosynovitis. The secondary purpose was to report clinical differences in patients that chose surgical intervention following conservative management for de Quervain's tenosynovitis.Methods: Following initial consultation with the treating orthopedic surgeon and throughout the conservative management time frame, 240 injuries (93%) were splinted, 230 (89%) patients were given an oral NSAID, and patients spent an average of 12 ± 6.9 weeks in occupational therapy for treatment of their injuries. In addition, 165 (64%) received an initial cortisone injection into the first dorsal extensor tendon compartment of the wrist. 44-Forty-four (17%) of these patients received a second cortisone injection, and 6 (2%) received a third cortisone injection with at least 2 to 3 months between each injection.Result: Our study found that following conservative management there was significant improvement in the severity of symptoms, which was recorded using visual analog scale (VAS) scores. However, 58 (22%) patients converted to surgical release for de Quervain's tenosynovitis, reported a higher post-management severity of symptoms (p<.001) than the patients who were solely treated conservatively.Conclusions: Patients showed significant improvement following conservative treatment, such as splinting, NSAIDs, occupational therapy and corticosteroid injections. This study also confirms that patients who are surgically treated are associated with higher pain levels post-conservative treatment and post-management than those solely treated conservatively. Finally, this data suggests that those patients in this patient population who experience de Quervain's tenosynovitis through traumatic onset are more likely to require surgical intervention.

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‘The side of my wrist hurts’: De Quervain’s tenosynovitis

Abstract: • De Quervain's tenosynovitis is a stenosing tenosynovitis with multiple possible aetiologies.

Cited by 17 publications

References 18 publications

The effectiveness of corticosteroid injection and splint in diabetic de Quervain's tenosynovitis patients

The effectiveness of corticosteroid injection and splint in diabetic de Quervain's tenosynovitis patients

Quervain's Tenosynovitis, General Description

Clinical Implications and Treatment Algorithm for Patients with de Quervain’s Tenosynovitis

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