Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Abi‐Rafeh, Jad; Jaberi, Mehrad Mojtahed; Kazan, Roy; Alabdulkarim, Abdulaziz; Boily, Mathieu; Thibaudeau, Stéphanie

doi:10.1097/prs.0000000000008792

Cited by 7 publications

(5 citation statements)

References 54 publications

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“…Kulthanan and Chareonwat [ 33 ] investigated septal prevalence in patients with de Quervain compared to cadavers of assumably physiological states. The authors reported that septa were more commonly found in patients with de Quervain than in cadavers, which was in good agreement with systemic reviews of Lee et al [ 1 ], Bonczar et al [ 34 ] and Abi-Rafeh et al [ 31 ]. Therefore, the presence of an intra-compartmental septum within the 1st EC might also be associated with de Quervain tenosynovitis etiology or pathophysiology.…”

Section: Discussionsupporting

confidence: 83%

“…The presence of intra-compartmental septa was attributed to the failure of conservative treatment (corticosteroid injection) for de Quervain tenosynovitis [ 5 , 11 ]. Several studies indicated that ultrasound-guided corticosteroid injection resulted in a superior accuracy over blind injections when sub-compartments were present within the 1st EC [ 4 , 8 , 30 , 31 ]. Therefore, we recommend ultrasound-guided corticosteroid injection over blind injection for conservative de Quervain tenosynovitis treatment.…”

Section: Discussionmentioning

confidence: 99%

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Relationship to the superficial radial nerve and anatomic variations of the first extensor compartment in Thai population: a basis for successful de Quervain tenosynovitis treatment

Pasiphol,

Agthong,

Thamrongskulsiri

et al. 2024

Anat Cell Biol

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Knowledge of the superficial radial nerve (SRN) relationship and anatomic variations of the first extensor compartment (1st EC) will contribute to a better outcome of de Quervain tenosynovitis treatment. We dissected 87 embalmed cadaveric wrists to determine the relationship of the SRN, the 1st EC length, distance from the proximal and distal 1st EC borders to radial styloid process (RSP), abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slip numbers, and the presence of septum. Our results revealed SRN crossing over the 1st EC in 59.5%. The lateral branch of the superficial radial nerve to the 1st EC midline in most cases (61.9%) except for one specimen, where lateral antebrachial cutaneous nerve was the closest. Distances from proximal and distal 1st EC borders to the RSP were 19.7±4.1 mm and 7.6±1.8 mm, respectively. Extensor retinaculum (ER) width over 1st EC (1st EC length) was 14.8±3.2 mm. Complete and incomplete septa were found in 17.2%, and 42.5%, respectively. The most frequent APL tendon slip number in the compartment was two in overall 47 specimens (54.0%). Almost all compartments (85 specimens; 97.7%) contained one EPB tendon slip. We detected bilateral EPB absence in one cadaver. Moreover, we recorded a tendon slip from extensor pollicis longus traveling into 1st EC bilaterally in one cadaver and observed the EPB muscle belly extension into 1st EC in 9 wrists. Awareness of 1st EC anatomic variations would be essential for successful surgical and nonsurgical outcomes.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Relationship to the superficial radial nerve and anatomic variations of the first extensor compartment in Thai population: a basis for successful de Quervain tenosynovitis treatment

Pasiphol,

Agthong,

Thamrongskulsiri

et al. 2024

Anat Cell Biol

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“…Identifying the dorsal tubercle of the radius was emphasized in a Delphi study of anatomical structures useful to rheumatologists [ 17 ]. Pantukosit’s fascinating report [ 8 ] observed that all but one of 30 FIS cases occurred on the dominant side, and most of the patients were rice farmers who performed repetitive, forceful wrist movements. All the patients reported pain, while 22 experienced swelling and 12 had a tendon rub.…”

Section: Discussionmentioning

confidence: 99%

“…The EPB originates distal to the APL and joins it, following the same trajectory and relationships. These muscles extend obliquely in a lateral and caudal direction and reach the hand under the extensor retinaculum in the first dorsal compartment in a single synovial sheath, which is wholly or partially septated in approximately 40% of cadaveric specimens [ 8 ]. These tendons are inserted on the thumb, with the APL on the lateral side of the first metacarpal base and the EPB on the dorsal side of the proximal phalanx.…”

Section: Introductionmentioning

confidence: 99%

Examining the Forearm Intersection through Palpation and Ultrasonography

Naredo,

Murillo-González,

Mérida Velasco

et al. 2024

Diagnostics

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Background: Forearm intersection syndrome causes pain, swelling, and a rub at the dorsal distal forearm where the first extensor compartment muscles intersect with the second compartment tendons. Although primary care settings tend to treat mild cases, high-performance athletes may suffer from severe symptoms that require surgery. This proof-of-concept study aims to help detect the anatomical substrate of forearm intersection syndrome using palpation and ultrasonography when available. Methods: Five individuals were studied using independent palpation and ultrasonography to identify the first dorsal compartment muscles and the second dorsal compartment tendons. The distances between the dorsal (Lister’s) tubercle of the radius and the ulnar and radial edges of the first dorsal compartment muscles were measured to determine the location and extent of the muscle–tendon intersection. The palpatory and ultrasonographic measurements were compared using descriptive statistics and the paired t-test. Results: The mean distances from the dorsal tubercle of the radius to the ulnar and radial borders of the first dorsal compartment muscles were 4.0 cm (SE 0.42) and 7.7 cm (SE 0.56), respectively, based on palpation. By ultrasonography, the corresponding distances were 3.5 cm (SD 1.05, SE 0.47) and 7.0 cm (SD 1.41, SE 0.63). Both methods showed a similar overlap length. However, ultrasonography revealed a shorter distance between the dorsal tubercle of the radius and the ulnar border of the first compartment than palpation (p = 0.0249). Conclusions: Our findings indicate that a basic knowledge of anatomy should help health professionals diagnose forearm intersection syndrome through palpation and, if available, ultrasonography.

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“…In a review and meta‐analysis by Abi‐Rafeh et al, incomplete septum and complete septum separation were not observed. Using a random effects model in the surgical population with clinical DQT (6 studies, 212 wrists), the general prevalence of intercompartmental septum was calculated to be 67% by Abi‐Rafeh et al 19 The septum prevalence in the general cadaver population was determined to be 35% (5 studies, 150 wrists) 19 …”

Section: Discussionmentioning

confidence: 99%

The place of B‐mode ultrasonography, shear‐wave elastography, and superb microvascular imaging in the diagnosis of De Quervain tenosynovitis

Ten,

Asfuroğlu,

Eskandari

et al. 2024

J of Clinical Ultrasound

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PurposeSuperb microvascular imaging (SMI) and Shear wave elastography (SWE) are newly developed ultrasonographic diagnostic tools used to support the diagnosis of De Quervain tenosynovitis (DQT). The aim of this study was to examine the capacity to differentiate between the wrist with DQT and the healthy wrist, as well as the potential for predicting the disease's severity using B‐mode ultrasonography, SWE, and SMI.MethodsA total of 19 cases with unilateral clinical DQT were included in the prospective study. The wrists of these cases without DQT clinic constituted the control group.ResultsThe SWE parameters of m/s and kPa cutoff values were ≤5.225 and ≤ 77.65, respectively, in the wrists with DQT compared to the wrists not diagnosed with DQT (p < 0.001). Regarding SMI findings no microvascularity was determined in the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon sheaths of the wrists without DQT, and a significant increase was observed in the degree of microvascularity as the clinical severity of DQT increased.ConclusionSWE results can differentiate between the presence and absence of DQT. SMI grading of the APL and EPB tendon sheaths may be helpful to the clinician in deciding the clinical severity of DQT.

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Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Cited by 7 publications

References 54 publications

Relationship to the superficial radial nerve and anatomic variations of the first extensor compartment in Thai population: a basis for successful de Quervain tenosynovitis treatment

Relationship to the superficial radial nerve and anatomic variations of the first extensor compartment in Thai population: a basis for successful de Quervain tenosynovitis treatment

Examining the Forearm Intersection through Palpation and Ultrasonography

The place of B‐mode ultrasonography, shear‐wave elastography, and superb microvascular imaging in the diagnosis of De Quervain tenosynovitis

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