Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Condition/Disorder Synonyms ++ Washer woman's sprain Radial styloid tenosynovitisDeQuervain’s tenosynovitis De Quervain diseaseDe Quervain's tenosynovitis De Quervain's stenosing tenosynovitis Mother's wrist Mommy thumb +++ ICD-9-CM Code ++ 727.04 Radial styloid tenosynovitis +++ ICD-10-CM Code ++ M65.4 Radial styloid tenosynovitis [de Quervain] +++ Preferred Practice Pattern ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation1 +++ Key Features +++ Description ++ Inflammation and thickening of the abductor pollicis longus and extensor pollicis brevis synovial tendon sheaths and extensor retinaculum2Named after Swiss surgeon, Fritz de Quervain +++ Essentials of Diagnosis ++ Tenderness with palpationPositive resisted isometric test in thumb abduction and extensionFinkelstein’s test is best for diagnosis +++ General Considerations ++ Entrapment tendonitis, tendon friction Often a direct result of repetitive stress or chronic overuse of extensor and abductor muscles causing excessive friction to tendon sheathPatients likely to develop adhesions and irritation between tendons and their sheaths +++ Demographics ++ Mostly found in women aged 30 to 50 years, possibly due to great angle of the styloid processCommon among individuals who perform any activity requiring repetitive hand and wrist movementAt-risk populations includeMassage therapistsMusicians MillinersGardenersOffice workersPregnant and postpartum women +++ Clinical Findings +++ Signs and Symptoms ++ Forearm painCrepitus of tendons within the extensor sheathUnilateral palmer pain and swellingTendon friction rubUpper-extremity painWeak thumb abductionDecreased grip strengthWrist pain and swellingDecreased abduction ROM of the carpometacarpal (CMC) joint, thumbPain with thumb activity, worsens when combined with wrist radial or ulnar deviation +++ Functional Implications ++ Pain with pinching, grasping, squeezing, holding heavy objects, wringingPain with movements of hand and wristLoss of strengthTendon rupture +++ Possible Contributing Causes ++ Occupations that require repetitive use of hands for excessive periods of timeA direct trauma to the tendon or wristInflammatory arthritis, such as rheumatoid arthritis +++ Differential Diagnosis ++ Rheumatoid arthritisCarpal tunnelOsteoarthritisIntersection syndrome: pain 2 to 3 inches proximal to wristInfectionDorsal wrist ganglion (tumor)Trigger fingerScaphoid fracture (history of trauma, tenderness over snuffbox)Wartenberg’s syndrome: radial nerve entrapment at the forearm +++ Means of Confirmation or Diagnosis +++ Imaging ++ X-ray to rule out arthritis at thumb CMC joint +++ Diagnostic Procedures ++ Resisted isometric testingFinkelstein’s test +++ Treatment +++ Medication ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.