De Quervains disease

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Patient Information

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.