De Quervains disease
- 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.
- Investigations are not required for treatment or referral for suspected De Quervains Tenosynovitis.
- Activity modification / Avoidance of exacerbating activities.
- Simple thumb and wrist immobilization (thumb spica splint) – not shown to be beneficial in isolation.
- 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.