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De Quervain's Tenosynovitis

Patient-facing topic on De Quervain's tenosynovitis (first dorsal compartment) — diagnosis, conservative management, and indications for de Quervain's release.

65 citationsUpdated Sep 2026
Illustration: De Quervain's Tenosynovitis

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

De Quervain's tenosynovitis involves the first extensor compartment, where anatomical variations are clinically relevant to pathophysiology and treatment [1]. Diagnosis is primarily clinical; wrist radiography does not influence management [2]. The tethered thumb maneuver elicits a characteristic response that supports diagnosis and helps determine the treatment algorithm [3]. If diagnostic maneuvers produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes [4]. No sufficient scientific evidence confirms a causal relationship between the condition and occupational risk factors [10].

Corticosteroid injection is the preferred initial nonsurgical treatment and the only available option that can potentially modify the disease course [5]. It leads to treatment success 73.4% of the time within two injections [11] and is superior to thumb spica splinting [15]. One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provide short-term improvement compared to placebo [16]. While success rates decrease with multiple injections, repeat injections remain a viable clinical option [36]. Patients with diabetes mellitus have a decreased probability of success following a single injection, though the effectiveness of each additional injection does not appear to diminish [28].

Surgical release remains the gold standard treatment for refractory cases [12]. A longitudinal incision offers easy compartment identification, more complete release of tendon sheath and peritendinous adhesions, and less risk of palmar subluxation [12]. Endoscopic release is an effective and safe alternative that provides earlier postoperative improvement, fewer superficial radial nerve complications, and greater scar satisfaction compared with open release [34]. Although endoscopic procedures are associated with a slight increase in operation time [40], they yield good clinical outcomes with minimal morbidity [13]. Pulley reconstruction should be considered part of surgical treatment and provides satisfactory medium-term results [7]. The scientific literature on management is sparse, largely limited to uncontrolled cohorts and low-quality randomized trials [27].

Anatomy & Pathophysiology

Anatomical Variations

The first dorsal compartment exhibits significant anatomical variability that influences surgical planning. An additional septum is present in 34% of cadaveric analyses [18], while supernumerary tendons or tendon slips are commonly found within the compartment [103]. Septal or aberrant compartments are also documented features of this region [103]. These anatomical variations are frequently bilateral in the population [103]. During surgical intervention, the superficial branch of the radial nerve is expected to be encountered in more than 50% of patients [88]. Functionally, tendon slips of the abductor pollicis longus that insert into the base of the first metacarpal are capable of providing complete palmar abduction of the first digit in the absence of nonmetacarpal tendons [104].

Pathophysiology

De Quervain's syndrome is defined as a condition where the abductor pollicis longus and extensor pollicis brevis tendons in the first dorsal compartment become inflamed through friction, leading to pain [6]. This process involves compromised blood flow and nutrition, which causes adhesions and tendon stenosis [6]. The condition may also involve myxoid degeneration, a process where connective tissues are replaced by gelatinous or mucoid substance [6]. Histopathology of the abductor pollicis longus and extensor pollicis brevis tendon sheaths is characterized by myxoid degeneration with dense fibrous tissue and mucopolysaccharide accumulation [18]. These histopathological changes are consistent with an intrinsic degenerative mechanism rather than an inflammatory etiology [18].

A morphologically abnormal first dorsal compartment causes impingement and compression of the abductor pollicis longus and extensor pollicis brevis tendons [18]. This impingement and compression increase the tensile load of the irregular retinaculum, stimulate nociceptors, and cause pain [18]. No study has established an association between hand usage at work or trauma with De Quervain's tenosynovitis [18]. Instead, the condition results from anatomical factors associated with some mechanical stressors [52]. Women are more affected than men due to manual work influencing first compartment dynamics [52]. In specific populations, such as volleyball players, training intensity is a major factor in determining De Quervain's disease [52]. Operative treatment for distal radius fractures confers a slightly greater risk of developing De Quervain's tenosynovitis within 1 year of injury or surgery [100].

Diagnostic Considerations

The tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support diagnosis and assist in determining treatment algorithms [3]. Clinicians must consider that an intraneural ganglion cyst in the superficial radial nerve can mimic the symptoms of de Quervain tenosynovitis without the usual presentation of painful paresthesias [38]. Ultrasonography provides a reliable evaluation of the pertinent first extensor compartment anatomy and improves the accuracy of needle placement for first extensor compartment injection [55]. Additionally, wrist position has an influence on in vivo extensor pollicis brevis tendon excursion measures [68].

Classification

Anatomical Variations and Subcompartmentalization

Anatomical variations in the first extensor compartment are clinically relevant to the pathophysiology and treatment of De Quervain's tenosynovitis [1]. Cadaveric analyses identify an intracompartmental septum within the first dorsal compartment in 34% of wrists [18]. The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis [42]. Specifically, the extensor pollicis brevis tendon is likely to reside in a subcompartment particularly in patients with de Quervain's disease [43]. The prevalence of a separate compartment for the extensor pollicis brevis is significantly higher in patients with de Quervain tenosynovitis than in the general population [54]. In a prospective study of non-operative treatment, 73% of wrists with unsatisfactory outcomes that underwent operative release were found to have a separate compartment for the extensor pollicis brevis [54].

Diagnostic Imaging and Radiography

Ultrasound is a useful imaging technique for diagnosing de Quervain's disease and provides important information about anatomic variations within the first extensor compartment [41]. Ultrasonography consistently provided a reliable evaluation of the pertinent first extensor compartment anatomy and improved the accuracy of needle placement for first extensor compartment injection in a cadaver model [55]. Wrist radiography does not influence management of patients presenting with de Quervain tendinopathy [2]. Though considered as a manifestation of de Quervain's disease by some authors, styloid abnormalities do not affect the outcome of management [21].

Etiology and Risk Factors

The cause of De Quervain's tenosynovitis does not correlate with manual work or trauma based on cadaver studies, authors' clinical cases, and systematic review [14]. The belief that de Quervain's tenosynovitis is caused by work-related injury is misdirected, as no study has established an association between hand usage at work or trauma with the condition [18]. Risk factors for de Quervain's tenosynovitis include female gender, age greater than 40, and black race [33]. Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity [20].

Pathophysiology and Histology

De Quervain's syndrome is defined as a condition where abductor pollicis longus and extensor pollicis brevis tendons become inflamed through friction in the first dorsal compartment, leading to pain [6]. The condition is referred to by various terminologies including tendinosis, tendinopathy, and tenovaginitis/tenosynovitis [6]. The histopathology of abductor pollicis longus and extensor pollicis brevis tendon sheaths in de Quervain's tenosynovitis is characterized by myxoid degeneration with dense fibrous tissue and mucopolysaccharide accumulation [18]. Myxoid degeneration changes are consistent with an intrinsic degenerative mechanism rather than an inflammatory etiology, questioning the nomenclature of tenosynovitis [18].

Clinical Presentation and Physical Examination

De Quervain's tenosynovitis causes pain around the dorsoradial aspect of the wrist, just proximal to the radial styloid [18]. The condition is precipitated by a thickened first dorsal compartment and its tendons, the abductor pollicis longus and extensor pollicis brevis [18]. A narrow, morphologically abnormal first dorsal compartment causes impingement and compression of the abductor pollicis longus and extensor pollicis brevis tendons [18]. Impingement and compression of the tendons increase the tensile load of the irregular retinaculum, stimulate nociceptors, and cause pain [18]. The tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis [3]. The tethered thumb maneuver can assist in determining an effective treatment algorithm for de Quervain tenosynovitis [3].

Clinical Presentation

Symptoms and Signs

Patients with de Quervain's tenosynovitis typically present with pain around the dorsoradial aspect of the wrist, just proximal to the radial styloid [18]. Clinical examination reveals tenderness and swelling directly over the first dorsal compartment [57]. Symptoms are exacerbated by ulnar deviation of the thumb, a strong grasp combined with wrist flexion and radial deviation, or firm pinching of the index finger and thumb [57].

Diagnostic Tests

A staged version of the Finkelstein test is described as reliable, easy, and reproducible for diagnosing de Quervain's tendonitis while causing minimal discomfort compared to traditional descriptions [47]. The wrist hyperflexion and abduction of the thumb (WHAT) test is a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff’s Test [57]. Finkelstein's test is superior to Eichhoff's test in the investigation of de Quervain's disease [60]. The WHAT test can diagnose tendon instability following successful release of the first extensor compartment, which may present with a normal Eichhoff's test, Finkelstein's test, and ultrasonography [59]. An intraneural ganglion in the superficial radial nerve can mimic the symptoms of de Quervain tenosynovitis without the usual presentation of painful paresthesias [38].

Risk Factors and Etiology

The cause of De Quervain's tenosynovitis does not correlate with manual work or trauma based on cadaver studies, clinical cases, and systematic review [14]. De Quervain’s syndrome may be associated with trauma, extensor carpi ulnaris involvement, ligament instability, or repetitive strain, suggesting it may not be an isolated pathology [6].

Diagnostic Imaging

De Quervain disease is diagnosed clinically and no imaging studies are required when the presentation is clear [61]. Wrist imaging is required only in the presence of associated processes that may need to be evaluated, such as previous distal radius or scaphoid fracture, arthritis of the thumb, and instability of the wrist [61]. In a study of 200 patients, 69.1% had at least one positive radiographic finding, with carpometacarpal joint arthritis being the most common finding seen in 30.9% of cases [58]. No radiographic findings altered the course of treatment in patients with isolated de Quervain's tenosynovitis [58]. Styloid abnormalities do not affect the outcome of management for de Quervain's disease [21]. Ultrasound is a worthwhile preoperative investigation in cases of de Quervain's disease [50].

Patient Factors and Expectations

Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year [32]. More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [19]. Addressing misconceptions about the consequences of de Quervain's tenosynovitis and symptom duration allows patients to make informed decisions about treatment [9]. Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [25].

Investigations

Imaging: An intraneural ganglion cyst can mimic the symptoms of de Quervain tenosynovitis without the more usual presentation of painful paresthesias [38].

Anatomical Variations: The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [23].

Physical Examination: The tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [3]. Using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with de Quervain's disease may be invalid [48].

Treatment

Non-Operative Management

Corticosteroid injections represent a primary conservative intervention, achieving treatment success in 73.4% of patients within two injections [11]. A single cortisone injection alleviates symptoms in 82% of patients, with over half remaining symptom-free for at least 12 months [51]. While patients with diabetes mellitus have a decreased probability of success following a single injection compared to nondiabetic patients, the effectiveness of each additional injection does not appear to diminish [28]. Combined techniques often yield superior results; corticosteroid injection combined with thumb spica casting outperforms injection alone in treatment success and functional outcomes [65]. Additionally, the combined use of corticosteroid injection and hand therapy intervention decreases pain and symptomology, though the strength of this evidence is limited [49]. Preliminary results indicate that betamethasone is a superior treatment compared to ketorolac injection [67].

Thumb spica splinting assists with pain management by immobilizing the thumb and wrist joints, thereby preventing thumb MP joint flexion and wrist ulnar deviation [62]. However, studies have not shown splinting to provide long-lasting relief beyond allowing the joints to rest in an immobilized position [62]. Physical modalities such as iontophoresis with dexamethasone may improve functional outcomes, while therapeutic pulsed ultrasound may be effective in decreasing pain [66]. Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively [20].

Operative Management

Indications: Surgical intervention is indicated for patients with de Quervain's disease who are unresponsive to non-operative treatments [31, 40]. Outcomes for surgical treatment are generally excellent [78].

Surgical Approach / Technique: Endoscopic release provides earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction compared with open release [34]. One-portal endoscopic-assisted release is an effective and safe minimal invasive procedure with similar complication rates to open and endoscopic procedures [31]. Endoscopic release of the extensor compartment is effective and safe despite a slight increase in operation time [40]. Open release using a longitudinal incision offers the advantage of easy identification of the compartment, more complete releases of tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [12]. A Bruner-type incision of the first dorsal compartment retinaculum allows for a loose tendon sheath reconstruction which theoretically prevents tendon subluxation while providing acceptable relief of tenosynovitis with no increase in recurrence rates over the baseline [63]. The pulley reconstruction technique gives satisfactory medium-term results and should be considered part of the surgical treatment [7]. In a small series (n = 22) of ultrasound-guided percutaneous tendon release, the duration of surgery was 8 minutes (range: 4–18 minutes), it was performed in office surgery with no morbidities noticed, and all patients improved from a preoperative quickDASH score of 59 (range: 28–71) to a postoperative quickDASH score of 9 (range: 0–25) [44].

Adjuncts: When first dorsal compartment release is performed during volar approach for distal radius fracture fixation, it demonstrates a significantly greater reduction in de Quervain disease symptoms in the release group compared with the no release group during short-term follow-up [69].

Other Considerations: Anatomic variations are frequently encountered in recalcitrant cases, with examples including multiple slips of APL and EPB in its own separate compartment [78]. The dorsal retinaculum is released during surgical treatment to prevent volar tendon subluxation [78]. Complications of surgical treatment include iatrogenic injury to the superficial branch of the radial nerve, tendon subluxation, complex regional pain syndrome (CRPS), and recurrence due to incomplete release [78].

Diagnostic & Prognostic Considerations

The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [3]. Addressing misconceptions about the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [9]. More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [19]. The cause of De Quervain's tenosynovitis does not correlate with manual work or trauma from cadaver studies, authors' clinical cases, and systematic review [14].

Complications

Tendon Subluxation: Surgical release of De Quervain's tenosynovitis using a longitudinal incision carries a less risk of palmar subluxation of tendons compared to other approaches [12].

Other Considerations: The presence of an intracompartmental septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [23]. In a review of 100 medicolegal cases, reasons for poor results in de Quervain's disease were identified, contributing to a shift in surgical perception from uniformly successful outcomes to potential failure [17]. The presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in de Quervain’s syndrome [37]. In a prospective study of 99 wrists, 30 of 33 wrists with unsatisfactory non-operative outcomes were found to have a separate compartment for the extensor pollicis brevis upon subsequent operative release [54]. The prevalence of a separate compartment for the extensor pollicis brevis is significantly higher in patients with de Quervain tenosynovitis than in the general population, as shown in anatomical studies of cadavers [54].

Recovery

Non-Operative Management: Corticosteroid injection combined with a short duration of immobilization serves as the primary and effective treatment for de Quervain tenosynovitis [22]. Most informed patients initially elect this symptomatic treatment [32]. A single cortisone injection alleviates symptoms in 82% of patients, with over half remaining symptom-free for at least 12 months [51]. Pain and clinical outcomes significantly improve following injection [24]. Most patients experience symptom resolution within one year [32]. Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection compared to nondiabetic patients, although the effectiveness of each additional injection does not appear to diminish in this population [28].

Operative Management: Longitudinal incision offers the advantage of easy identification of the compartment, more complete releases of tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [12]. Endoscopic release of the extensor compartment is associated with a slight increase in operation time compared to open release [40].

Prognosis and Patient Factors: Only 34.9% of patients with new stenosing tenosynovitis required surgery within a 2-year follow-up period [87]. Most patients with new stenosing tenosynovitis who progress to surgery do so within 1 year of presentation [87].

Key Evidence

  • [L4] These variations are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis. [1] (10.1016/j.bjps.2016.08.020)
  • [L3] Wrist radiography does not influence management of patients presenting with de Quervain tendinopathy. [2] (10.1055/s-0037-1606124)
  • [L4] The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm. [3] (10.1016/j.jhsa.2013.04.017)
  • [L4] If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain. [4] (10.1016/j.jhsa.2014.09.024)
  • [L4] According to the limited evidence available, injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment. [5] (10.1016/j.jhsa.2008.12.030)
  • [L4] [6] (10.1177/1758998315599796)
  • [L4] The authors believe the technique gives satisfactory medium-term results and should be considered part of the surgical treatment for de Quervain tenosynovitis. [7] (10.1055/s-0035-1556862)
  • [L4] Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management. [8] (10.1016/j.jhsg.2024.01.009)
  • [L3] Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values. [9] (10.1097/corr.0000000000001577)
  • [L1] No sufficient scientific evidence was provided to confirm a causal relationship between de Quervain tenosynovitis and occupational risk factors. [10] (10.1097/01.prs.0000434409.32594.1b)
  • [L3] This study indicates that corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. [11] (10.1177/1558944716681976)
  • [L4] Surgical release of De Quervain's tenosynovitis remains the gold standard treatment, and longitudinal incision offers advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions and less risk of palmar subluxation of tendons. [12] (10.1007/s12306-018-0585-1)
  • [L4] The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity. [13] (10.4055/cios.2014.6.4.405)
  • [Paper] The cause of De Quervain's tenosynovitis does not correlate with manual work or trauma from cadaver studies, authors' clinical cases, and systematic review. [14] (10.1055/s-0039-1683984)
  • [L1] The efficacy of corticosteroid injections for de Quervain's tenosynovitis has been studied in only one small controlled clinical trial, which found steroid injections to be superior to thumb spica splinting. [15] (10.1002/14651858.cd005616.pub2)
  • [L1] One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo. [16] (10.1186/1471-2474-10-131)
  • [L4] [17] (10.1054/jhsb.1999.0277)
  • [L1] [18] (10.1055/s-0039-1677741)
  • [L3] More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis. [19] (10.1097/corr.0000000000000992)
  • [L4] Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively. [20] (10.1177/1753193416646722)
  • [L4] Though considered as a manifestation of de Quervain's disease by some authors, styloid abnormalities do not affect the outcome of management as proved in this study. [21] (10.1007/s11552-010-9258-8)
  • [L1] Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis. [22] (10.1016/j.jhsa.2024.03.003)
  • [L4] The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome. [23] (10.1177/17531934231214137)
  • [L1] Pain and clinical outcomes significantly improved after corticosteroid injection in de Quervain's disease. [24] (10.1016/j.otsr.2019.11.015)
  • [L4] Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis. [25] (10.1016/j.jhsa.2023.07.005)
  • [L4] The scientific literature on the surgical and nonsurgical management of de Quervain tendinopathy is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials. [27] (10.1016/j.jhsa.2013.06.003)
  • [L4] Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish. [28] (10.1016/j.jhsa.2022.02.018)
  • [L4] One portal endoscopic assisted release of the extensor compartment is an effective and safe minimal invasive procedure with similar complication rates reported previously in open and endoscopic procedures in patients with de Quervain's disease who are unresponsive to non-operative treatments. [31] (10.1016/j.aott.2018.10.004)
  • [L4] Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year. [32] (10.1007/s12593-009-0018-3)
  • [L2] Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race. [33] (10.1016/j.jhsa.2008.08.020)
  • [L1] Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release. [34] (10.1302/0301-620x.95b7.31486)
  • [L2] Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option. [36] (10.1016/j.jhsa.2021.04.018)
  • [L3] [37] (10.1177/1753193415611414)
  • [L4] [38] (10.1055/s-0034-1384746)
  • [L4] Endoscopic release of the extensor compartment seems to be an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a little increase in operation time. [40] (10.1016/j.bjps.2011.05.015)
  • [L5] Ultrasound is a useful imaging technique for diagnosing de Quervain's disease and provides important information about anatomic variations within the first extensor compartment. [41] (10.1136/bcr-2021-242173)
  • [L3] The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis. [42] (10.1177/1558944718810864)
  • [L4] When it does, particularly in patients with de Quervain's disease, it is likely to reside in a subcompartment of the first dorsal compartment. [43] (10.1016/j.jhsa.2008.12.015)
  • [L4] [44] (10.1055/s-0039-1678688)
  • [L4] The authors describe a staged version of the Finkelstein test that is reliable, easy, and reproducible for diagnosing de Quervain's tendonitis while causing minimal discomfort compared to traditional descriptions. [47] (10.1016/j.jhsa.2010.05.022)
  • [L3] This finding may question the validity of using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with de Quervain's disease. [48] (10.1197/j.jht.2008.03.004)
  • [L1] The paper supports the combined use of corticosteroid injection and hand therapy intervention to decrease pain and symptomology as measured through provocative testing in patients with de Quervain's, though the strength of the evidence is limited. [49] (10.1016/j.jht.2015.12.004)
  • [L4] Ultrasound is a worthwhile preoperative investigation in case of de Quervain's disease. [50] (10.1007/s12593-009-0001-z)
  • [L4] A single cortisone injection was effective in alleviating symptoms of de Quervain tendinopathy in 82% of patients, with over half remaining symptom-free for at least 12 months. [51] (10.1016/j.jhsa.2014.12.027)
  • [L4] [52] (10.1177/0363546504268134)
  • [L5] Ultrasonography consistently provided a reliable evaluation of the pertinent first extensor compartment anatomy and, in this cadaver model, improved the accuracy of needle placement for first extensor compartment injection. [55] (10.5435/jaaos-d-15-00753)
  • [L2] [57] (10.1177/1753193412475043)
  • [L4] [58] (10.1055/s-0040-1716522)
  • [L5] [59] (10.1177/1753193414561399)
  • [L3] [60] (10.1055/s-0038-1626690)
  • [L5] [61] (10.5435/00124635-200712000-00009)
  • [L4] [62] (10.1007/s11552-014-9649-3)
  • [L4] [63] (10.1177/15589447231218403)
  • [L2] The combined technique of corticosteroid injection and thumb spica casting was better than injection alone in the treatment of de Quervain tenosynovitis in terms of treatment success and functional outcomes. [65] (10.1016/j.jhsa.2013.10.013)
  • [L4] This study demonstrated that iontophoresis with dexamethasone may improve functional outcomes, while therapeutic pulsed ultrasound may be effective in decreasing pain in patients with de Quervain's tenosynovitis. [66] (10.1016/j.jht.2014.08.032)
  • [L1] Preliminary results indicate that betamethasone is a superior treatment for De Quervain's tenosynovitis. [67] (10.1016/j.jhsa.2017.06.086)
  • [L4] In vivo EPB tendon excursion measures have been quantified, and wrist position has been found to have an influence on excursion. [68] (10.1016/j.jht.2017.12.004)
  • [L1] The current results demonstrated a significantly greater reduction in de Quervain disease symptoms in the release group compared with the no release group during the short-term follow-up. [69] (10.1016/j.jhsg.2024.03.009)
  • [L2] Only 34.9% of patients with new stenosing tenosynovitis required surgery within a 2-year follow-up period, with most progressing to surgery within 1 year of presentation. [87] (10.1016/j.jhsa.2017.06.088)
  • [L2] The anatomical findings are consistent with previous studies, with an expectation to encounter the superficial branch of the radial nerve in more than 50% of patients. [88] (10.1055/s-0039-1688700)
  • [Paper] Operative treatment for distal radius fractures confers a slightly greater risk of developing DeQuervain tenosynovitis within 1 year of injury or surgery. [100] (10.1177/15589447251366456)
  • [Paper] There is immense anatomical variation present in the first dorsal compartment of the wrist, supernumerary tendons/tendon slips are commonly found, there is variation of insertion present in the population, septum/aberrant compartment is also present, and bilateral variations are present in the population. [103] (10.1007/s12593-012-0073-z)
  • [L4] Tendon slips of the APL that insert into the base of the first metacarpal are capable of providing complete palmar abduction of the first digit in the absence of nonmetacarpal tendons. [104] (10.1177/1558944721999734)

See Also

References

[1] Surgical anatomy of the first extensor compartment: A systematic review and comparison of normal cadavers vs. De Quervain syndrome patients. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2017. DOI: 10.1016/j.bjps.2016.08.020

[2] Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients. Journal of Wrist Surgery. 2017. DOI: 10.1055/s-0037-1606124

[3] Tethered Thumb Sign: A Unique Observation in the Physical Examination of de Quervain Tenosynovitis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.04.017

[4] Longitudinal Split Tear of the Extensor Pollicis Brevis Tendon: Report of 2 Cases. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.09.024

[5] Nonsurgical Treatment for de Quervain's Tenosynovitis. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.030

[6] De Quervain’s syndrome: It may not be an isolated pathology. Hand Therapy. 2015. DOI: 10.1177/1758998315599796

[7] Pulley Reconstruction As Part of the Surgical Treatment for de Quervain Disease: Surgical Technique with Medium-Term Results. Journal of Wrist Surgery. 2015. DOI: 10.1055/s-0035-1556862

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[9] Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001577

[10] Systematic Review and Meta-Analysis on the Work-Related Cause of de Quervain Tenosynovitis. Plastic and Reconstructive Surgery. 2013. DOI: 10.1097/01.prs.0000434409.32594.1b

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[12] Functional outcome of De Quervain’s tenosynovitis with longitudinal incision in surgically treated patients. MUSCULOSKELETAL SURGERY. 2019. DOI: 10.1007/s12306-018-0585-1

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[19] Which Psychological Variables Are Associated With Pain and Function Before Surgery for de Quervain’s Tenosynovitis? A Cross-sectional Study. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000992

[20] Post-traumatic de Quervain’s syndrome: a rare condition, often diagnosed late. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416646722

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[24] Prospective randomized comparison of ultrasonography-guided and blind corticosteroid injection for de Quervain's disease. Orthopaedics & Traumatology: Surgery & Research. 2020. DOI: 10.1016/j.otsr.2019.11.015

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[28] Effectiveness of Corticosteroid Injections in Diabetic Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2022.02.018

[31] One portal endoscopic release of the first extensor compartment in de Quervain's disease. Acta Orthopaedica et Traumatologica Turcica. 2020. DOI: 10.1016/j.aott.2018.10.004

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[36] De Quervain Tenosynovitis: An Evaluation of the Epidemiology and Utility of Multiple Injections Using a National Database. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2021.04.018

[37] Presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in de Quervain’s syndrome. Journal of Hand Surgery (European Volume). 2015. DOI: 10.1177/1753193415611414

[38] Intraneural Ganglion in Superficial Radial Nerve Mimics de Quervain Tenosynovitis. Journal of Wrist Surgery. 2014. DOI: 10.1055/s-0034-1384746

[40] Does endoscopic release of the first extensor compartment have benefits over open release in de Quervain’s disease?. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2011. DOI: 10.1016/j.bjps.2011.05.015

[41] Type II de Quervain’s disease: depicting subcompartmentalisation with ultrasound. BMJ Case Reports. 2021. DOI: 10.1136/bcr-2021-242173

[42] Prevalence of a Septated First Dorsal Compartment Among Patients With and Without De Quervain Tenosynovitis: An In Vivo Anatomical Study. HAND. 2018. DOI: 10.1177/1558944718810864

[43] Thumb Interphalangeal Joint Extension By the Extensor Pollicis Brevis: Association With a Subcompartment and de Quervain's Disease. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.015

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[49] Clinical Relevance Commentary on: Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: A systematic review and meta-analysis. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2015.12.004

[50] Preoperative ultrasound in de Quervain’s disease: an investigation worth doing. Journal of Hand and Microsurgery. 2009. DOI: 10.1007/s12593-009-0001-z

[51] de Quervain Tendinopathy: Survivorship and Prognostic Indicators of Recurrence Following A Single Corticosteroid Injection. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.12.027

[52] De Quervain Disease in Volleyball Players. The American Journal of Sports Medicine. 2005. DOI: 10.1177/0363546504268134

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