De Quervains disease

Patient Information

https://patient.info/bones-joints-muscles/tendinopathy-and-tenosynovitis-tendinosis

GP Information

Background Information

• A self-limiting inflammation of the first extensor compartment of the wrist (APL, EPB).
• Common in females 30-50 and racquet sports.
• Patients typically complain of causing radial sided wrist or thumb pain, occasionally radiating proximally in to the forearm.
• Examination may reveal localised swelling and erythema, tenderness on palpation over the 1st extensor compartment and a positive Finkelstein’s or modified Eichoffs test.

Investigation Guidelines

• Investigations are not required for treatment or referral for suspected De Quervains Tenosynovitis.

Management Recommendations

• Activity modification / Avoidance of exacerbating activities.
• NSAIDs.
• Simple thumb and wrist immobilization (thumb spica splint) – not shown to be beneficial in isolation.
• Physiotherapy.
• Steroid injection (image guided).
• Referral indications: Diagnostic uncertainty, Referral for physiotherapy, Failure to respond to 3 months conservative management or image guided steroid injections, Symptoms significantly limiting activities of daily living.