Histological Appearances in Post-Partum de Quervain’s Disease

Abstract

Six patients who developed de Quervain's disease during pregnancy or within 12 months of childbirth were treated surgically. Histopathological examination of the tendon sheaths using alcian blue stain showed that myxoid degeneration was responsible for the thickening observed in the sheath. Characteristic intramural deposits of mucopolysaccharides were present, predominantly in the subsynovial region. Acute or chronic inflammatory changes were not seen. These findings were the same as those described in patients with de Quervain's disease unrelated to pregnancy or childbirth.

Manual Physical Therapy Examination and Intervention of a Patient With Radial Wrist Pain: A Case Report

“…It is unlikely that these techniques would affect a stenosis of the extensor tendon com- partments 9 or tendon sheath degeneration. 6,22 Although arthroses of the CMC, IC, or RC joints were potential diagnoses, repeat imaging was not deemed necessary, given the patient's normal radiographs from 2 years prior and her positive treatment response.…”

“…It is unlikely that passive accessory motion testing or joint mobilizations would have such an immediate effect on the proposed causes of de Quervain's disease, which are either a stenosis of the extensor tendon compartments 9 or degeneration of the tendon sheath. 6,22 Although further testing was warranted, the first CMC joint was considered a possible pain source due to mild tenderness on palpation and grind testing. A good prognosis was anticipated based on her immediate decrease in pain following RC joint ulnar glide mobilizations.…”

“…6 Recent histological studies, however, have found that this disorder is characterized by degeneration and thickening of the tendon sheath and is not an active inflammatory condition. 6,22 Typical physical therapy management of de Quervain's disease and other wrist disorders consists of: thumb and wrist splinting; physical agents such as ice, heat, transcutaneous electrical nerve stimulation (TENS), ultrasound, and iontophoresis; friction massage; joint mobilization; active exercise; and patient education. 16,28 Several studies have concluded that local steroid injections are an effective treatment option for de Quervain's disease, 7,20,23,31 especially in treating patients with moderate to severe symptoms that affect their daily activity levels.…”

Tenossinovite e sinovite do primeiro compartimento extensor do punho: o que o ultrassonografista precisa saber

“…The term tenosynovitis is also somewhat inappropriate, since the main histological marker for the condition is the mucopolysaccharide deposition in the tendon sheath, indicating degenerative process (3,4) . More precisely, the external reticular layer of the sheath is histologically normal, while the internal layer demonstrates myxoid or mucinous degeneration, and the central layer demonstrates vascular proliferation, and macrophage infiltration.…”

Functional outcome of surgically treated De Quervain's tenosynovitis

“…Despite the name Tenosynovitis the histopathological feature of this disorder is not inflammation, but is deposition of mucopolysaachride, myxoid degeneration and neovascularisation as seen in different fibrous metaplasia. 1,2,3 . The condition is caused by impaired and repetitive gliding of the tendons, microtrauma due to overuse of the first dorsal compartment tendons (Abductor pollicis longus and extensor pollicis brevis).in long standing cases of de Quervains tenosynovitis thickening of extensor retinaculum can be seen.…”