De Quervains Disease.

De Quervains Disease
De Quervain's Disease is an inflammation of
the sheaths of the tendons that move the
thumb up and out (at the base of the thumb ).

These tendons include

The extensor pollicis brevis and
The abductor pollicis longus tendons.
Figure: Area of De Quervains Disease.
Causes of De Quervains
Disease:

Overuse of the thumb and wrist but it also

occurs spontaneously.

It can occur as a result of an acute injury to

the involved area (direct blow to the forearm
or wrist, falling on the thumb).
Patho physiology:
Increased vascularization of the outer
sheath with edema.

Increases the thickness of the sheath around

the EPB & APL.

Constricting the existing tendon.

Microadhesions may form between

the sheath and the tendon.

Sheath thickness two to four times its normal size.

Signs and Symptoms:

Gradual onset of pain over the area and

increase over time.

Swelling near the base of the thumb.

Numbness in the back of the thumb and

index finger.

Difficulty in moving the thumb and wrist

when grasping or pinching.
 Signs and Symptoms:
Usually a women aged 40-50

There may be a history of unaccustomed activity

such as pruning roses or wringing out clothes

Pain on the radial side of the wrist

over the radial styloid and the tendon sheath feels

thick and hard.

Tenderness is most acute at the very tip of the

radial styloid
 Diagnosis:
Special Test:
The Finkelstein Test.

Figure: Finkelstein Test.

Treatment:

Medical management:
Anti-inflammatory drug;
Cortisone injection;

Surgery:
The goal of surgery is to give the tendons more
space so they no longer rub on the inside of the
tunnel. To do this, the surgeon performs a surgical
release of the roof of the tunnel.
Terima Kasih