de Quervain’s Tenosynovitis with Accessory Abductor Pollicis Longus Tendon and ‘Wartenberg’s syndrome’ - A Case Report

Abstract

Background: de Quervain's tenosynovitis (dQT) is focal soft-tissue rheumatism of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. The Swiss surgeon Fritz de Quervain first demonstrated the disorder in 1895. Anatomical variation of the first wrist extensor compartment, for example, accessory APL, can be associated with de Quervain's tenosynovitis. Sometimes, dQT may coexist with superficial radial nerve (SRN) compression, widely known as 'Wartenberg syndrome.' Case presentation: In the present case study, clinical features of de Quervain's tenosynovitis have been described in a 45-year-old housewife without any known risk factor for the disorder. The patient also complained of focal swelling and tenderness with positive Finkelstein test, besides wrist usage pain. An ultrasonogram of the wrist's first extensor compartment depicted a thick, hypoechoic tenosynovial sheath encircling two APL and one EPB tendons. Swollen first extensor wrist compartment compressing the SRN led to tingling and dysesthesia, 'Wartenberg syndrome.' Conclusion: de Quervain's tenosynovitis with accessory abductor pollicis longus tendon may present with ‘Wartenberg syndrome’. Keywords: deQuervains tenosynovitis, accessory abductor pollicis tendon, Wartenberg syndrome, ultrasonography, case report.