De-quervains
First describe by swiss surgeon de quervains in 1895.
It is a painful condition of the wrist joint due to inflammation of extensor pollicis brevis, abductor pollicis longus tendon and it is characterized by pain and swelling all over the radial styloid process.
It is also known as New mother wrist, black berry thumb and gamer's thumb,Mommy's thumb, washerman's thumb.
Inflammation of tendons can increase pressure on nerves and cause symptoms like numbness, paresthesia on the dorsal aspect of the hand.
Epidemiology
More common in females
Causes-
Unknown
Mostly associated with rheumatoid arthritis, gout, osteoarthritis.
otherwise ganglion,lymphedema, chronic overuse and pregnancy
Risk factor
Hand activities like golfing.
Carpentry using hammers
ringing activities tennis,, grasping, playing video games
Clinical features-
Pain (dorso- lateral aspect of wrist)
Swelling( radial styloid process and snuff box)
Pain during thumb extension and abduction.
Tenderness over radial styloid
Nodular swelling over radial styloid
Weakness, numbness, paresthesia.
Differential diagnosis
Osteoarthritis (carpometacarpal joint)
Rheumatoid arthritis
Trigger finger
Radial styloid fracture
Radial neuritis
Diagnosis
Physical examination
Tenderness
Swelling
Painful movement( in thumb extension and abduction and ulnar deviation)
Treatment-
Conservative-
Provide test
Forearm to thumb splint
Activity modification
Avoid repetitive stress
Corticosteroids
Ice packs(for swelling)
Surgical management-
Rarely surgery
Surgery