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DeQuervain's Stenosing Tenosynovitis / Tenovaginitis
Definition: DeQuervain's tenosynovitis is the result of a stenosis of the common sheath enveloping the extensor pollicis brevis and abductor pollicis longus tendons.
Causes: The exact cause of DeQuervain's tenosynovitis / tenovaginitis, remains idiopathic. The condition is however, strongly associates with repetitive overuse of the thumb, with movement requiring pollux extention and abduction, with eccentric lowering of the wrist into ulnar deviation. Such activites include washing dishes, opening the lids off jars, and more recently the use of video-game controller with analogue sticks.
Examination: In cases of DeQuervain's tenosynovitis/tenovaginitis, patients will usually with pain within the anatomical snuff-box of the symptomatic side. Heat, and oedema may also be appreciated over the same area. Patients suffering from DeQuervain's tenosynovitis/tenovaginitis usually report a difficulty in gripping.
Orthopaedic test for DeQuervain's tenosynovitis/tenovaginitis:
Finkelstein's test: instruct the patient to grip their thumb of the symptomatic side with the same hand and slowly ulnar deviate whilst maintaining the grip. A positive is indicated by an aggravation in symptoms.