Incidence of de Quervain's Tenosynovitis in a Young, Active Population

Wolf, Jennifer Moriatis; Sturdivant, Rodney X.; Owens, Brett D.

doi:10.1016/j.jhsa.2008.08.020

Cited by 127 publications

(105 citation statements)

References 9 publications

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“…A wide range of prevalence of DQD (0.7-36%) has been reported in working populations, depending on the definition used and the populations involved (4)(5)(6)(7)(8)(9)(10)(11). An incidence of 0.6 per 1000 person-years among men and 2.8 per 1000 person-years among women was recently reported in a large population of young US military personnel (12). Although not caused only by work, DQD (1415 cases in 2007) represents about 8% of the musculoskeletal disorders of the hand-wrist region receiving compensation each year in France.…”

mentioning

confidence: 99%

Risk factors for de Quervain’s disease in a French working population

Manac’h¹,

Roquelaure²,

Ha³

et al. 2011

Scand J Work Environ Health

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mentioning

confidence: 99%

Risk factors for de Quervain’s disease in a French working population

Manac’h¹,

Roquelaure²,

Ha³

et al. 2011

Scand J Work Environ Health

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“…It has an incidence of approximately 0.94 to 6.3 per 1000 person-years [15,20] and more frequently affects women, older individuals, and African-Americans [20]. It is associated with pregnancy and lactation [2].…”

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confidence: 99%

Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

Kwon

Choi

Koh

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The intracompartmental septum in the first extensor compartment in patients with de Quervain's disease has been associated with disease development and prognosis. However, with the exception of surgical exploration, there is no way of detecting the septum. Questions/Purposes We evaluated the accuracy of sonography for identifying the intracompartmental septum in the first extensor compartment in patients with de Quervain's disease using surgical findings as the reference standard. Patients and Methods We performed surgical release of the first extensor compartment in 43 wrists of 40 patients who were unresponsive to nonoperative treatment. In each case, a sonographic evaluation was performed before surgery by a radiologist and the sonographic and surgical findings were compared. Results Sonography identified the intracompartmental septum in 19 of the 19 septum-present wrists and absence of the septum in 23 of the 24 septum-absent wrists. The sensitivity of sonography was 100% (95% confidence interval, 80%-100%), its specificity 96% (95% confidence interval, 78%-100%), accuracy 98% (95% confidence interval, 87%-100%), positive predictive value 95% (95% confidence interval, 74%-100%), and negative predictive value 100% (95% confidence interval, 83%-100%). Sonography also identified septum-like structures in 15 of 37 (41%) asymptomatic contralateral wrists.

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“…In some texts, FT is typically considered a confirmatory test for DQT because of its high sensitivity and specificity (Figure 3). 7 However, other literature has demonstrated that while the test maintains its sensitivity, it lacks specificity in localizing the pain. 8 Pain from IS, basal MCP joint arthritis, and scaphoid arthritis can each produce a false-positive finding with FT. 8 A painless thumb grind maneuver, described as an axial compression and slight rotation of the MCP joint, will aid in ruling out arthritic pathology.…”

Section: Discussionmentioning

confidence: 99%

Intersection Syndrome: The Subtle Squeak of an Overused Wrist

Skinner

2017

J Am Board Fam Med

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Patient histories that include wrist pain can be pivotal in the distinction between intersection syndrome (IS) and the more common de Quervain's tenosynovitis (DQT). Presented here is a 26-year-old pregnant woman with a history of rowing who developed left radial/dorsal wrist pain and a rubbing/squeaking sensation. Nine months of conservative DQT therapy and a landmark-guided corticosteroid injection failed to relieve her symptoms. An in-clinic ultrasound showed tenosynovitis at the intersection of the first and second compartments, confirming a diagnosis of IS. She found immediate relief with ultrasoundguided saline hydrodissection, the injection of saline into the intercompartmental space to reduce adhesions. Both DQT and IS are overuse injuries caused by repetitive wrist extension, as occurs in rowing, and either condition can worsen after pregnancy. Distinguishing the subtleties between DQT and IS can be challenging. Close attention to the patient's description of the pain can guide treatment, potentially expediting recovery. In addition, saline hydrodissection can be both a diagnostic tool and a potentially therapeutic alternative to steroid injections for such tendinopathies. Wrist pain can account for as much as 20% of musculoskeletal complaints in the ambulatory care setting.1 Among the more prevalent diagnoses are tendinopathies of the thumb and wrist, including de Quervain's tenosynovitis (DQT) and intersection syndrome (IS). 1 While the initial management for both conditions can be similar, understanding their subtle differences may lead to faster recovery and less risk of complications at subsequent visits if initial management should fail. Clues from the patient history can be pivotal in the distinction between IS and the more common DQT. In refractory cases or those in which steroid injections may not be favored, saline hydrodissection (injection of saline into the intercompartmental space to reduce adhesions) may present a diagnostic and therapeutic alternative. Case PresentationA pregnant 26-year-old woman whose dominant hand is the left hand presented to primary care with a complaint of progressively worsening left wrist pain for the past few weeks. She described a constant, dull ache that had since developed intermittently sharp, shooting pains up her forearm, radiating from a focus just proximal to the metacarpals along the dorsal aspect. She added that there is a "rubbing/friction sensation" over the point of maximum tenderness. She was 16 weeks into an uncomplicated pregnancy. While in college she was an avid rower, which involved frequent flexion and extension of her left wrist against the resistance of the oar. This dull ache was familiar. However, the sharp shooting pains were different. She had a new hobby baking cupcakes, which required frequently lifting large bags of flour.Her initial wrist examination revealed no swelling, deformities, or ecchymosis. She had tenderness over the distal aspect of the left radius 2 to 4 cm This article was externally peer reviewed.

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Incidence of de Quervain's Tenosynovitis in a Young, Active Population

Cited by 127 publications

References 9 publications

Risk factors for de Quervain’s disease in a French working population

Risk factors for de Quervain’s disease in a French working population

Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

Intersection Syndrome: The Subtle Squeak of an Overused Wrist

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