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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.

Overview

De Quervain's tenosynovitis is a rare condition where surgical release is typically required due to persistent triggering [1]. While patients may initially favor nonsurgical management, corticosteroid injection remains the only available treatment capable of modifying the disease course and is therefore the preferred initial intervention [2, 3]. This approach, often combined with short-duration immobilization, serves as the primary and effective treatment strategy [13].

Clinical outcomes vary based on patient comorbidities and injection frequency. Corticosteroid injections achieve a 73.4% success rate within two injections [11], though the success rate for treatment decreases with multiple injections [15]. Patients with diabetes mellitus demonstrate a decreased probability of success following a single injection compared to nondiabetic patients, yet the effectiveness of each additional injection does not appear to diminish in this population [12]. Repeat injections remain a viable clinical option with a high rate of success [15].

Surgical release is indicated for patients with significant functional impairment or pain interference. Those scoring lower than 40 for physical function or higher than 60 for pain interference have significantly increased odds of eventually undergoing surgical release [26]. Addressing patient misconceptions regarding symptom duration and consequences facilitates informed decision-making aligned with patient values [4]. Current literature on management is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials [16].

Anatomy & Pathophysiology

Diagnostic evaluation of radial-sided wrist pain requires distinguishing de Quervain tenosynovitis from mimics. The tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis [10], whereas diagnostic maneuvers producing pain outside the radial styloid suggest the need for advanced imaging to identify other anatomic causes [6]. While nonoperative options are commonly used as first-line treatment for tenosynovitis of the hand and wrist [24], ultrasonography consistently provides a reliable evaluation of the pertinent first extensor compartment anatomy [55]. In a cadaver model, ultrasonography improved the accuracy of needle placement for first extensor compartment injection [55], with the short axis proving more accurate than the long axis for ultrasound measurements of the first extensor compartment [56].

Differential Diagnosis: Anomalous muscles such as the flexor carpi radialis brevis should be included in the differential diagnosis of radial side wrist pain [50]. The flexor carpi radialis brevis muscle can become clinically symptomatic when its tendon intersects with the flexor carpi radialis tendon, causing localized tendinosis and tenosynovitis [47]. Extensor indicis proprius syndrome is characterized by dorsal wrist pain and synovitis within the fourth dorsal compartment [51]. MRI is the imaging modality with the greatest ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity [27].

Complications & Surgical Considerations: Extensor retinaculum reconstruction can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5]. Screw penetration greater than 1.5 mm in the third and fourth extensor compartments is likely to cause problems [45]. Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare [28].

Classification

Other Considerations: Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1]. Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2]. 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 [3]. 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 [4]. Procedures such as extensor retinaculum reconstruction can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5]. 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 [6]. De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7]. 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 [8]. Styloid abnormalities, though considered as a manifestation of de Quervain's disease by some authors, do not affect the outcome of management [9]. 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 [10]. In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [17]. Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role [25]. The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis [33]. Quality information about De Quervain's tendinitis is available on the internet and is most likely to be found using the search term De Quervain's tenosynovitis and in the first 10 results of an internet search [37].

Clinical Presentation

De Quervain's tenosynovitis presents as a rare condition where triggering necessitates surgical release in most cases [1]. While patients often favor initial nonsurgical management [2], corticosteroid injection remains the only available nonsurgical treatment capable of modifying the disease course, establishing it as the preferred initial therapy [3]. This intervention demonstrates a 73.4% success rate within two injections [11], and the combined use of corticosteroid injection with hand therapy further decreases pain and symptomology on provocative testing [30]. Addressing patient misconceptions regarding symptom duration and consequences is critical for informed decision-making, as negative perceptions and pain catastrophizing correlate with worse baseline pain and reduced function in those awaiting decompression [4, 14].

History taking should note that pregnancy is a significant risk factor associated with increased odds of the condition [23], and clinicians must recognize that persistent radial wrist pain following injury may indicate de Quervain's syndrome [20]. Although post-traumatic de Quervain's is uncommon and often initially overlooked, it is typically successfully treated non-operatively once diagnosed [8]. In a proportion of patients, the syndrome may be secondary to underlying wrist pathology from previous trauma [7], whereas no relationship exists between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].

Physical examination relies on specific maneuvers to confirm diagnosis. The proposed tethered thumb maneuver elicits a characteristic response in many patients, supporting diagnosis and guiding treatment algorithms [10]. A staged version of the Finkelstein test is reliable, easy, and reproducible for diagnosing tendonitis while causing minimal discomfort compared to traditional descriptions [31]. If diagnostic maneuvers elicit pain outside the radial styloid, advanced imaging is required to identify alternative anatomic causes [6].

Regarding surgical planning and anatomical variants, styloid abnormalities do not influence management outcomes [9]. The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release [19]. However, if constriction involves only the extensor pollicis brevis within a separate compartment, exploration of both compartments is advised [17]. Procedures such as extensor retinaculum reconstruction can be broadly applied without specialized equipment to optimize function [5].

Investigations

Plain radiography: While styloid abnormalities do not affect the outcome of management in de Quervain's disease [9], plain radiographs are indicated when diagnostic maneuvers elicit pain in a location other than the radial styloid to identify other anatomic causes [6]. Tenosynovitis with psammomatous calcification must be differentiated from intra-articular lesions, particularly in atypical presentations [43].

MRI: No other imaging modality can compete with MRI's ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity [27]. MRI is particularly relevant given that de Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].

Other Considerations: Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1]. Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2], with injection of corticosteroids being the only available nonsurgical treatment that can potentially modify the course of the disease and therefore the preferred initial treatment [3]. Addressing misconceptions about the consequences and duration of symptoms allows patients to make informed decisions about treatment that best matches their values [4]. The proposed tethered thumb maneuver elicits a characteristic response in many patients, supporting the diagnosis and assisting in determining an effective treatment algorithm [10]. Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role [25], and the presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release [19]. In cases where constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [17]. Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially but is typically successfully treated non-operatively once diagnosed [8]. Clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome [20]. Pregnancy is a significant risk factor associated with increased odds of de Quervain tenosynovitis [23]. Growth hormone abuse is associated with a more recalcitrant form of the condition that does not respond well to nonsurgical treatment, leading to an increased likelihood of surgical decompression [42]. No relationship was established between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].

Treatment

Non-Operative

Corticosteroid injection is the only nonsurgical treatment capable of modifying the disease course and remains the preferred initial therapy [3]. A single injection of 1 ml triamcinolonacetonide 10 mg/ml administered by general practitioners improves symptoms in the short term compared to placebo [22], with one study reporting an 82% success rate for symptom alleviation where over half of patients remained symptom-free for at least 12 months [32]. Overall, corticosteroid injections achieve treatment success in 73.4% of cases within two injections [11]. While the success rate for treatment decreases with multiple injections [15], repeat corticosteroid injections remain a viable clinical option with a high rate of success [15]. The combination of corticosteroid injection and thumb spica casting yields superior treatment success and functional outcomes compared to injection alone [34]. Corticosteroid injection paired with short-duration immobilization remains the primary effective treatment [13]. Adjunctive modalities such as iontophoresis with dexamethasone may improve functional outcomes, and therapeutic pulsed ultrasound may effectively decrease pain [35]. Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection compared to nondiabetic patients, though the effectiveness of each additional injection in diabetic patients does not appear to diminish [12]. Addressing patient misconceptions regarding consequences and symptom duration facilitates informed decision-making [4]. Post-traumatic de Quervain's syndrome, though rare and often initially overlooked, is typically successfully treated non-operatively once diagnosed [8].

Operative

Indications: Surgical release is indicated for triggering due to de Quervain tenosynovitis, a rare condition where surgery is required in most cases [1]. Nonoperative options are commonly used as first-line treatment, yet questions remain regarding the timing to advance to operative intervention [24]. Patients awaiting surgical decompression often exhibit worse pain and reduced function at baseline if they hold negative perceptions of consequences or demonstrate pain catastrophizing [14].

Surgical Approach / Technique: Endoscopic release provides earlier postoperative improvement, fewer superficial radial nerve complications, and greater scar satisfaction compared with open release [21]. Extensor retinaculum reconstruction procedures can be broadly applied without specialized equipment to optimize function [5]. Additionally, first dorsal compartment release during a volar approach for distal radius fracture fixation reduces symptoms in patients with pre-existing De Quervain disease [38].

Other Considerations: Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9]. The scientific literature on surgical and nonsurgical management is sparse, limited largely to uncontrolled cohorts with low-quality randomized trials [16].

Complications

Other Considerations: Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1]. Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, though it is typically successfully treated non-operatively once diagnosed [8]. De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7], and clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome [20]. Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9], and the presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [19]. Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis [39], whereas risk factors in a young, active population include female gender, age greater than 40, and black race [40]. No relationship was established between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].

Diagnostic and Management Considerations: Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2], and injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis [3]. Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11], with one or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leading to short-term improvement compared to placebo [22]. Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [13]. Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, though the effectiveness of each additional corticosteroid injection for de Quervain tenosynovitis in diabetic patients does not appear to diminish [12]. 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 [6]. 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 [4]. 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 [14].

Recovery

Light activity (weeks): Patients may return to desk work, driving, and light activities of daily living (ADLs) following initial nonsurgical management, which is the preferred first-line treatment [2, 3]. Corticosteroid injection combined with a short duration of immobilization remains the primary effective treatment strategy [13]. While most patients with new stenosing tenosynovitis progress to surgery within 1 year of presentation, only 34.9% required surgery within a 2-year follow-up period [44].

Full activity (months): Surgical release is indicated for triggering due to de Quervain tenosynovitis, a rare condition requiring intervention in most cases [1]. Endoscopic release appears to provide earlier improvement after surgery compared with open release, characterized by fewer superficial radial nerve complications and greater scar satisfaction [21]. Similarly, the tendoscopic technique offers earlier symptom relief and recovery with fewer complications and more desirable scarring while maintaining equivalent long-term outcomes [41].

Complete recovery / outcome plateau (months): Final functional outcomes stabilize after the initial recovery phase, though the scientific literature on management is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials [16]. Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection compared to nondiabetic patients, yet the effectiveness of each additional injection in diabetic patients does not appear to diminish [12]. Although success rates for treatment decrease with multiple injections, repeat injections remain a viable clinical option with a high rate of success, achieving treatment success 73.4% of the time within 2 injections [11, 15].

Rehabilitation protocol: Addressing misconceptions regarding the consequences and duration of symptoms allows patients to make informed decisions about treatment matching their values [4]. The proposed tethered thumb maneuver elicits a characteristic response in many patients, supporting diagnosis and assisting in determining an effective treatment algorithm [10]. Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare [28].

Functional milestones: 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 [14]. 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 [26].

Other Considerations: De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].

Key Evidence

  • [L4] Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases. (10.1016/j.jhsg.2022.04.004)
  • [L4] Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management. (10.1016/j.jhsg.2024.01.009)
  • [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. (10.1016/j.jhsa.2008.12.030)
  • [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. (10.1097/corr.0000000000001577)
  • [L4] These procedures can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis. (10.1016/j.jhsa.2017.07.024)
  • [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. (10.1016/j.jhsa.2014.09.024)
  • [L4] The results suggest that de Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma. (10.1177/1758998315599796)
  • [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. (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. (10.1007/s11552-010-9258-8)
  • [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. (10.1016/j.jhsa.2013.04.017)
  • [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. (10.1177/1558944716681976)
  • [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. (10.1016/j.jhsa.2022.02.018)
  • [L1] Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis. (10.1016/j.jhsa.2024.03.003)
  • [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. (10.1097/corr.0000000000000992)
  • [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. (10.1016/j.jhsa.2021.04.018)
  • [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. (10.1016/j.jhsa.2013.06.003)
  • [L4] In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised. (10.2106/00004623-194931040-00019)
  • [L4] The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome. (10.1177/17531934231214137)
  • [Letter] The letter argues that the original report failed to demonstrate a causative link between trauma and de Quervain's syndrome, suggesting clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome. (10.1177/1753193417726668)
  • [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. (10.1302/0301-620x.95b7.31486)
  • [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. (10.1186/1471-2474-10-131)
  • [L3] Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of de Quervain tenosynovitis. (10.1016/j.jhsg.2025.100778)
  • [L4] Nonoperative options are commonly used as first-line treatment for tenosynovitis of the hand and wrist, but questions remain regarding when to advance to operative intervention. (10.2106/jbjs.rvw.o.00061)
  • [L4] Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role. (10.2106/00004623-198668060-00016)
  • [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. (10.1016/j.jhsa.2023.07.005)
  • [L4] No other imaging modality can compete with MRI's ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity. (10.1197/j.jht.2007.04.001)
  • [L4] Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare. (10.2106/00004623-197658060-00010)
  • [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. (10.1016/j.jht.2015.12.004)
  • [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. (10.1016/j.jhsa.2010.05.022)
  • [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. (10.1016/j.jhsa.2014.12.027)
  • [L3] The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis. (10.1177/1558944718810864)
  • [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. (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. (10.1016/j.jht.2014.08.032)
  • [L4] Quality information about De Quervain's tendinitis is available on the internet and is most likely to be found using the search term De Quervain's tenosynovitis and in the first 10 results of an internet search. (10.1007/s11552-014-9657-3)
  • [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. (10.1016/j.jhsg.2024.03.009)
  • [L3] Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis. (10.1186/s12891-015-0579-1)
  • [L2] Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race. (10.1016/j.jhsa.2008.08.020)
  • [L3] The results of this study suggest that tendoscopic technique for de Quervain's disease could provide earlier symptom relief and earlier recovery with fewer complications and more desirable scar, as well as equivalent successful long-term outcome, when compared with traditional open release technique. (10.1186/s13018-019-1393-5)
  • [L3] Our results suggest that growth hormone abuse is associated with a more recalcitrant form of de Quervain tenosynovitis that does not respond well to nonsurgical treatment, thus leading to increased likelihood of surgical decompression. (10.1177/0363546509337993)
  • [Case_report] This case highlights the importance of differentiating tenosynovitis with psammomatous calcification from intra-articular lesions, particularly in atypical presentations, and demonstrates the effectiveness of surgical intervention in resolving symptoms. (10.1016/j.jhsg.2023.08.001)
  • [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. (10.1016/j.jhsa.2017.06.088)
  • [L4] The study suggests that screw penetration greater than 1.5 mm in the third and fourth extensor compartments is likely to cause problems. (10.1177/1753193410392869)
  • [Case_report] The flexor carpi radialis brevis muscle can become clinically symptomatic when its tendon intersects with the flexor carpi radialis tendon, causing localized tendinosis and tenosynovitis. (10.1016/j.jhsa.2008.06.014)
  • [Case_report] Anomalous muscles such as the flexor carpi radialis brevis should be included in the differential diagnosis of radial side wrist pain. (10.1016/j.jhsa.2009.12.028)
  • [L4] The extensor indicis proprius syndrome is characterized by dorsal wrist pain and synovitis within the fourth dorsal compartment. (10.2106/00004623-196951080-00016)
  • [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. (10.5435/jaaos-d-15-00753)
  • [L5] The results support the idea that the short axis is more accurate than the long axis. (10.1177/1558944719873435)

See Also

References

[1] Triggering Thumb Is Not Always a Trigger Thumb. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.04.004

[2] De Quervain’s Tenosynovitis: As Seen from the Perspective of the Patient. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.01.009

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

[4] 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

[5] Extensor Retinaculum Reconstruction Using the Wide-Awake Approach. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.07.024

[6] 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

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

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

[9] Does Radial Styloid Abnormality in de Quervain's Disease Affect the Outcome of Management?. HAND. 2010. DOI: 10.1007/s11552-010-9258-8

[10] 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

[11] Effectiveness of Corticosteroid Injections for Treatment of de Quervain’s Tenosynovitis. HAND. 2016. DOI: 10.1177/1558944716681976

[12] 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

[13] Advancements in de Quervain Tenosynovitis Management: A Comprehensive Network Meta-Analysis. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.003

[14] 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

[15] 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

[16] Current Treatment of de Quervain Tendinopathy. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.06.003

[17] AN UNUSUAL FORM OF DE QUERVAINʼS SYNDROME. The Journal of Bone & Joint Surgery. 1949. DOI: 10.2106/00004623-194931040-00019

[18] Rheumatoid Tenosynovitis: Diagnosis and Treatment.. The Journal of Bone and Joint Surgery. American Volume. 1958.

[19] Prediction of an intracompartmental septum and its effect on outcomes of endoscopic release for de Quervain’s syndrome. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231214137

[20] Letter and reply. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417726668

[21] Endoscopicversusopen release in patients with de Quervain’s tenosynovitis. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b7.31486

[22] Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice. BMC Musculoskeletal Disorders. 2009. DOI: 10.1186/1471-2474-10-131

[23] Incidence and Risk Factors for Soft Tissue Hand and Wrist Conditions in Pregnancy and Postpartum. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100778

[24] Tenosynovitis of the Hand and Wrist. JBJS Reviews. 2016. DOI: 10.2106/jbjs.rvw.o.00061

[25] Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study.. The Journal of Bone & Joint Surgery. 1986. DOI: 10.2106/00004623-198668060-00016

[26] Association of Patient-Reported Outcomes Measurement Information System Measures With Injection and Surgical Treatment Response in Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.07.005

[27] Case Studies in the Diagnosis of Upper Extremity Pain Using Magnetic Resonance Imaging. Journal of Hand Therapy. 2007. DOI: 10.1197/j.jht.2007.04.001

[28] Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis. The Journal of Bone & Joint Surgery. 1976. DOI: 10.2106/00004623-197658060-00010

[30] 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

[31] Staged Description of the Finkelstein Test. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.05.022

[32] 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

[33] 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

[34] Corticosteroid Injection With or Without Thumb Spica Cast for de Quervain Tenosynovitis. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.10.013

[35] Effective Conservative Treatments for De Quervain's Tenosynovitis: A Retrospective Study. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2014.08.032

[37] The Internet as a Source of Information for De Quervain's Tendinitis. HAND. 2014. DOI: 10.1007/s11552-014-9657-3

[38] First Dorsal Compartment Release During Volar Approach for Distal Radius Fracture Fixation Reduces Symptoms in Patients With Pre-Existing De Quervain Disease. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.009

[39] Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data. BMC Musculoskeletal Disorders. 2015. DOI: 10.1186/s12891-015-0579-1

[40] Incidence of de Quervain's Tenosynovitis in a Young, Active Population. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.08.020

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