Materiały źródłowe

• #1 De Quervain Tenosynovitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442005/

  De Quervain tenosynovitis manifests as a thickening and myxoid degeneration of the tendon sheaths, specifically affecting the abductor pollicis longus and extensor pollicis brevis tendons as they traverse through the fibro-osseous tunnel situated along the radial styloid at the distal wrist. […] While the exact cause of de Quervain tenosynovitis is unclear, it has been attributed to myxoid degeneration with fibrous tissue deposits and increased vascularity rather than acute inflammation of the synovial lining. This deposition results in the thickening of the tendon sheath, painfully entrapping the abductor pollicis longus and extensor pollicis brevis tendons. […] The first compartment gets shrunk due to the thickening of the tendon sheath, causing a „stenosing” tenosynovitis of the wrist.

• #2 De Quervain Tenosynovitis: Practice Essentials, Anatomy, Etiology

  https://emedicine.medscape.com/article/1243387-overview

  De Quervain tenosynovitis is an entrapment tendinitis of the tendons contained within the first dorsal compartment at the wrist; it causes pain during thumb motion. […] The tendons of the abductor pollicis longus and the extensor pollicis brevis are tightly secured against the radial styloid by the overlying extensor retinaculum. Any thickening of the tendons from acute or repetitive trauma restrains gliding of the tendons through the sheath. Efforts at thumb motion, especially when combined with radial or ulnar deviation of the wrist, cause pain and perpetuate the inflammation and swelling. […] In de Quervain tenosynovitis, the first dorsal compartment is thickened, raising the skin and creating a prominence at the radial styloid.

• #3 de Quervain Tenosynovitis | PM&R KnowledgeNow

  https://now.aapmr.org/de-quervain-tenosynovitis/

  De Quervain tenosynovitis is characterized by pain and/or tenderness along the radial aspect of the wrist with associated focal swelling and antalgic thumb and wrist motion. The condition is exacerbated by flexion/extension of the thumb and radial-ulnar deviation of the wrist. […] While commonly labeled as de Quervain tenosynovitis, the condition is more consistent with tendinopathy, as histopathological evidence demonstrates this condition is not characterized by inflammation but rather by thickening of the tendon sheath itself. […] While the exact etiology of de Quervain tenosynovitis is unknown, its symptoms are attributed to non-inflammatory fibrous thickening of the first extensor compartment tendon sheath, which surrounds the APL and EPB, at the level of the radial styloid process. Rather than secondary to an acute inflammatory process, the thickening is a result of fibrous tissue deposits and increased vascularity along the extensor retinaculum. Overall, the thickening results in repetitive tension on the tendons causing swelling which restricts gliding of the tendons through the sheath. Symptoms are triggered by repetitive thumb movement, along with ulnar and radial wrist deviation.

• #4 De Quervain syndrome – Wikipedia

  https://en.wikipedia.org/wiki/De_Quervain_syndrome

  De Quervain syndrome occurs when two tendons that control movement of the thumb become constricted by their tendon sheath in the wrist. This results in pain and tenderness on the thumb side of the wrist. Radial abduction of the thumb is painful. On some occasions, there is uneven movement or triggering of the thumb with radial abduction. Symptoms can come on gradually or be noted suddenly. […] De Quervain syndrome involves noninflammatory thickening of the tendons and the synovial sheaths that the tendons run through. The two tendons concerned are those of the extensor pollicis brevis and abductor pollicis longus muscles. These two muscles run side by side and function to bring the thumb away from the hand (radial abduction). De Quervain tendinopathy affects the tendons of these muscles as they pass from the forearm into the hand via a fibro-osseous tunnel (the first dorsal compartment). Evaluation of histopathological specimens shows a thickening and myxoid degeneration consistent with a chronic degenerative process, as opposed to inflammation or injury. The pathology is identical in de Quervain syndrome cases seen in new mothers.

• #5 de Quervain tendinopathy – UpToDate

  https://www.uptodate.com/contents/de-quervain-tendinopathy

  de Quervain tendinopathy affects the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons in the first extensor compartment at the styloid process of the radius. It is characterized by pain and tenderness at the radial side of the wrist. Although de Quervain tendinopathy is often attributed to overuse or repetitive movements of the wrist or thumb, the cause is generally unknown. […] The etiology of de Quervain tendinopathy is not well-understood. In the past, it was frequently attributed to occupational or repetitive activities involving postures that maintain the thumb in extension and abduction. As an example, it has been thought that new mothers are at risk postpartum due to repetitive motion of hands required to lift and hold newborns. Hormonal causes and fluid retention are another plausible explanation. The evidence to support etiologic hypotheses is limited and is largely based on observational data. The histopathology does not demonstrate inflammation but rather myxoid degeneration (disorganized collagen and increased cellular matrix) in patients referred for surgery.

• #6 de Quervain Tenosynovitis | PM&R KnowledgeNow

  https://now.aapmr.org/de-quervain-tenosynovitis/

  New onset/acute tendons within the sheath become entrapped and irritated. This results in a fibroblastic and vascular response. This is followed by thickening and localized swelling of the tendon sheath and retinaculum. Histopathology is consistent with disorientation of the collagen fibrils with mucoid changes (not an inflammatory response). […] The presence of an intracompartmental septum is associated with an increased risk of non-operative treatment failure. […] Psychological distress may play a significant role in severity of symptoms, evidenced by one study finding high levels of correlation between pain catastrophizing, emotional distress, illness perception, and worsening pain and function.

• #7 De Quervain Tenosynovitis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116164/all/De_Quervain_Tenosynovitis

  First identified in 1895 by Fritz De Quervain, de Quervain tenosynovitis is a painful condition due to stenosis of the tendon sheath in the 1st dorsal compartment of the radial aspect of the wrist. […] Caused by repetitive motion of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) over the radial styloid with resultant metaplastic changes of the surrounding tendon sheath. […] Repetitive motions of the wrist and/or thumb result in microtrauma, metaplastic thickening of the tendons (EPB, APL), and narrowing of the surrounding tendon sheath. […] EPB and APL movement is resisted as they glide over the radial styloid, causing pain with movements of the thumb and wrist. […] Among individual undergoing release of the 1st dorsal compartment, histopathology of the tendon sheaths was characterized by myxoid degeneration with dense fibrous tissue and mucopolysaccharide accumulation.

• #8 De Quervain’s Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3723064/

  De Quervain’s disease, also called gamer’s thumb or mother’s thumb, is a common pathological condition of the wrist. Although the exact mechanism has not been determined, the cause of de Quervain’s disease is thought to be due to thickening of the synovial sheath containing the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons, which leads to irritation of the muscles, causing pain and swelling over the radial side of the wrist in patients along with an increased difficulty in gripping objects. […] Studies have shown de Quervain’s tendon sheaths to be thickened and fibrosed with nodularities, but no inflammatory changes being present. More commonly found in perimenopausal and pregnant women, de Quervain’s disease has been linked to overuse, although no clear evidence has supported this notion.

• #9 de Quervain Tenosynovitis | PM&R KnowledgeNow

  https://now.aapmr.org/de-quervain-tenosynovitis/

  Repetitive thumb and wrist motion lead to strain and friction where the two tendons form a sharp angle over the radial styloid, leading to tendon thickening within their extensor sheath. Over time, this leads to thickening of the retinaculum as well. Both factors restrict normal gliding of the tendons within the sheath. […] Notably, anatomical variants of the first extensor compartment have been shown to result in higher incidences of de Quervain tenosynovitis. In typical anatomy of the first extensor compartment, the APL and EPB tendons rest in a single fibro-osseous canal. The two most reported anatomical variants in the first compartment include two sub-compartments via the presence of a fibrous septum and multiple slips of the APL or EPB tendons. Both variants are believed to yield increased friction within the compartment and therefore more symptoms.

• #10 De Quervain tenosynovitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/de-quervain-tenosynovitis/symptoms-causes/syc-20371332

  De Quervain tenosynovitis affects the two tendons on the thumb side of the wrist. Tendons are ropelike structures that attach muscle to bone. […] Chronic overuse, such as repeating a particular hand motion day after day, may irritate the covering around the tendons. If the covering becomes irritated, the tendons can thicken and swell. This thickening and swelling restrict the movement of the tendons through the small tunnel that connects them to the base of the thumb. […] When you grip, grasp, clench, pinch or wring anything in your hand, two tendons in your wrist and lower thumb normally glide smoothly through the small tunnel that connects them to the base of the thumb. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement.

• #11 Time to Reconsider Occupation Induced De Quervain’s Tenosynovitis: An Updated Review of Risk Factors | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/36911-time-to-reconsider-occupation-induced-de-quervain-s-tenosynovitis-an-updated-review-of-risk-factors

  De Quervains tenosynovitis (DQT) is described to be an attritional and degenerative process, triggered by stenosing inflammation of the tendon sheath in the first dorsal compartment of the wrist. […] The two main anatomical variations associated with DQT are subcomparmentalization and multiple tendon slips of the abductor pollicus longus (APL) and extensor pollicus brevis (EPB) tendons. […] The belief that DQT is caused by work-related injury is incorrect, with no study to date establishing any association. […] Therefore, in addition to anatomical variation, other factors such as patient or occupation-specific factors may play a role in the development of DQT. […] A systematic review and meta-analysis including 80 articles found no evidence of a causal relationship between DQT and occupational risk factors, such as repetitive, forceful, and ergonomically stressful manual work. […] Stahl et al concluded that occupation exposure could not be shown to be a predisposing risk factor for DQT. […] Risk factors for DQT can be broadly split into anatomical, patient, and occupational factors.

• #12 ‘The side of my wrist hurts’: De Quervain’s tenosynovitis

  https://www1.racgp.org.au/ajgp/2019/november/side-of-my-wrist-hurts

  Many studies have looked at anatomical variations and at the prevalence of an intercompartmental septum within the first dorsal compartment. The prevalence of a septum ranges from 24% to 91% in the literature. Many authors link the presence of a septum to an increased likelihood of developing De Quervains tenosynovitis and also to the success of different treatment types. Those with an unidentified septum will not respond as well to corticosteroid injections because only one compartment tends to be injected. Those with a septum will need both compartments surgically released; therefore, it is important to identify the septum pre-operatively.

• #13 De Quervain tenosynovitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/de-quervain-tenosynovitis?lang=us

  De Quervain tenosynovitis, also known as washerwoman’s sprain/strain, is a painful stenosing tenosynovitis involving the first extensor (dorsal) tendon compartment of the wrist (typically at the radial styloid). This compartment contains the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. […] The APL and EPB tendons are tightly secured against the radial styloid by the overlying extensor retinaculum which creates a fibro-osseous tunnel approximately 1 cm in length. Thickening of the retinaculum and tendons from acute or repetitive trauma restrains normal gliding within the sheath. This causes inflammation and further edematous thickening of the tendon exacerbating the local stenosing effect. Microscopically there are inflammatory cells found within the tendon sheath. […] In ~10% of patients, there is an intertendinous septum between APL and EPB. The absence of a septum is associated with very high rates (almost 100%) of complete symptom resolution with conservative management. Presence of a septum increases the likelihood that surgical management will be required.

• #14 De Quervain Tenosynovitis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116164/all/De_Quervain_Tenosynovitis

  Cadaveric analyses have identified an additional septum within the 1st dorsal compartment in 3444% of individuals and subcompartmentalization has been reported in 8694% of patients with de Quervain tenosynovitis. […] Recent analyses suggest anatomic variability including tendon insertion variation and subcompartmentalization of the 1st dorsal compartment may be the greatest risk factors.

• #15 De Quervain’s Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3723064/

  It is important to understand the anatomical variations found within the compartment as failure to do so can result in inadequate surgical decompression and persistent pain. Anatomical studies have described the variations seen in tendon structure and organization of EPB and APL as well as the tendon sheath. […] If surgery fails to provide pain relief, consideration should be given to an unreleased subsheath or other conditions such as carpometacarpal joint, interphalangeal joint arthritis, or intersection syndrome.

• #16 de Quervain’s Tenosynovitis: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/rheumatoid-arthritis/de-quervains-disease

  De Quervain’s tenosynovitis is inflammation around the tendons in your thumb that leads to painful swelling. It’s also called de Quervain’s tendinosis or de Quervain’s tendinitis. Repetitive movements of your thumb or wrist cause the swelling. […] Doctors often dont know why you get de Quervain’s tenosynovitis. But it does result from: A direct blow to the thumb, Inflammatory conditions like rheumatoid arthritis, Overuse in hobbies, Repetitive workplace tasks. […] The goal of treatment is to ease the pain and inflammation when you move your thumb and to stop it from happening again. It involves: Medications. You’ll start with over-the-counter pain relievers like ibuprofen or naproxen to ease the swelling. If that doesn’t work, your doctor may inject steroids into the tight covering, or sheath, that surrounds your tendon. If you do this within 6 months after you notice symptoms, you might fully recover with no more treatment. […] When you have de Quervain’s tenosynovitis, you develop painful inflammation around the tendons in your thumb. The most common cause is repetitive activities that overwork those tendons. Rest, medication, and using a splint can help you recover. In rare cases, you might need surgery.

• #17 de Quervain’s Tenosynovitis: Causes & Treatment – familydoctor.org

  https://familydoctor.org/condition/de-quervains-tenosynovitis/

  De Quervain’s tenosynovitis is a painful condition that affects the tendons in your wrist. It occurs when the 2 tendons around the base of your thumb become swollen. The swelling causes the sheaths (casings) covering the tendons to become inflamed. This puts pressure on nearby nerves, causing pain and numbness. […] The most common cause of de Quervain’s tenosynovitis is chronic overuse of the wrist. Repetitive movements day after day cause irritation and pain. One common movement that causes it is lifting a child into a car seat. Another is lifting heavy grocery bags by the handles. Other causes could include a direct injury to the wrist or inflammatory arthritis. […] You are more likely to develop de Quervain’s tenosynovitis if: […] You are pregnant. Hormonal changes during pregnancy can cause it.

• #18 Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0579-1

  The etiology of de Quervain’s tenosynovitis (dQ) has been based on conflicting small case series and cohort studies lacking methodological rigor. A systematic review and meta-analysis regarding the etiology of dQ has revealed that expert opinions and case reports account for almost 60 % of the relevant literature. […] dQ is believed to result from repetitive, forceful, and ergonomically stressful work, from anatomic variations, hormonal influences or pregnancy, rheumatoid disease, trauma, or drugs, such as fluoroquinolone. […] Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for dQ. […] Our findings were similar to previous reports of dQ patients regarding the number of EPB and APL tendons and the presence of an accessory fibrous septum subdividing the first extensor compartment.

• #19 De Quervain’s Tenosynovitis: Effective Diagnosis and Evidence-Based Treatment | IntechOpen

  https://www.intechopen.com/chapters/64725

  Stahl et al. reviewed in a meta-analysis of 80 articles of an association between DQT and (1) repetitive, (2) forceful, or (3) ergonomically stressful manual work suggesting an odds ratio of 2.89 (95% CI, 1.45.97; p = 0.004). The analysis, however, found no evidence to support the Bradford Hill criteria for a causal relationship between de Quervains tenosynovitis and occupational risk factors.

• #20 What is De Quervain’s Tenosynovitis and How does it happen? | Merivale Hand Clinic

  https://www.merivalehandclinic.co.nz/resource-hub/what-is-de-quervains-tenosynovitis-and-how-does-it-happen/

  De Quervains tenosynovitis is a condition that affects two tendons that run from the back of the thumb down the side of the wrist. De Quervains tenosynovitis is the name given to the condition that occurs when these tendons are swollen and irritated. Swelling of the tendons, and the tendon sheath (a tunnel-like structure that the tendons travel through at the wrist), can cause pain and tenderness along the thumb side of the wrist. […] May be caused by repetitive movement of the thumb and wrist e.g., repetitive use of a screwdriver. […] Is the second most common hand and wrist problem occurring during pregnancy and the postpartum period. Fluid retention during the third trimester of pregnancy and repetitive picking up of the baby in particular positions that are needed for nursing and care of the child predispose new mothers to tenosynovitis. There is thought to be a hormonal contribution to this condition during the postpartum period, as symptoms usually resolve spontaneously after the termination of breastfeeding.

• #21 What is De Quervain’s Tenosynovitis and How does it happen? | Merivale Hand Clinic

  https://www.merivalehandclinic.co.nz/resource-hub/what-is-de-quervains-tenosynovitis-and-how-does-it-happen/

  Is up to 8-10 times more common in women than men. […] People who are older than 40 years of age are almost 4 times as likely to develop De Quervains tenosynovitis than people who are younger than 20 years of age. […] Diabetes and auto-immune disorders such as rheumatoid arthritis, lupus, and hypothyroidism are associated with an increased risk of diagnosis. […] When the tendons are inflamed, pain is experienced at the thumb side of the wrist and can travel up the forearm. The pain may appear either gradually or suddenly. The pain is usually worse when the hand and thumb are being used and swelling may be seen over the thumb side of the wrist. Pain and swelling commonly make movement the thumb and wrist difficult. […] The surgical procedure is performed under local anaesthetic and involves the surgeon cutting open the tendon sheath that the tendons travel through, to release pressure and reduce irritation.

• #22 Tenosynovitis (De Quervain’s syndrome) in pregnant women and new mothers | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/tenosynovitis

  De Quervains Tenosynovitis in pregnant women or new mothers has hormonal changes different from non-pregnant women. The hormones cause body fluid accumulation, especially in their wrists and hands, resulting in a water-logged and swollen tendon sheath. Moving wrists and hands causes rubbing of the tendon against its sheath, most often at the base of the thumbs and wrists. After giving birth, using their wrists to hold their babies for breastfeeding will lead to a higher risk of developing de Quervains tenosynovitis. […] De Quervains tenosynovitis is common in pregnant women, new mothers, and the elderly. […] The pain usually resolves after the treatment. Most of the time, only one injection is enough. For breastfeeding mothers, however, there is a minimal chance the condition may relapse in a few months requiring a second injection.

• #23 De Quervain’s Tenosynovitis | Wrist Pain Treatment | Pain Spa, Bristol, UK

  https://www.painspa.co.uk/condition/de-quervains-tenosynovitis/

  de Quervains tenosynovitis affects two thumb tendons: the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB). […] Repetitive or unaccustomed use of the thumb that involves pinching with the thumb while moving the wrist in radial and ulnar directions (eg, gripping and grasping) leads to thickening of the fibrous tendon sheath. Thickening results in inflammation and stenosis as the tendon sheath passes over the distal radius. […] Direct trauma to the first extensor (dorsal) compartment in the region of the radial styloid can also lead to inflammation in this region, subsequently leading to de Quervains tenosynovitis. […] In addition, systemic diseases like rheumatoid arthritis or calcium apatite deposition disease may lead to synovitis of the wrist, which may sometimes lead to de Quervains tenosynovitis.

• #24 De Quervain’s Tenosynovitis: Effective Diagnosis and Evidence-Based Treatment | IntechOpen

  https://www.intechopen.com/chapters/64725

  DQT affects both the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) at the point where they pass through a fibro-osseous tunnel (the first dorsal compartment) from the forearm into the hand. These tendons are responsible for bringing the thumb away from the hand as it lies flat in the plane of the palm (i.e., radial abduction). Similar to trigger finger (or stenosing flexor tenosynovitis), this disease involves a noninflammatory thickening of both the tendons and the tunnel (or sheath) through which they pass. […] Thickening of the retinaculum and tendons from acute or repetitive trauma restrains normal gliding within the sheath. This causes inflammation and further edematous thickening of the tendon exacerbating the local stenosing effect. […] Microscopically, there are inflammatory cells found within the tendon sheath.

• #25

  https://link.springer.com/article/10.1007/s11552-014-9649-3

  de Quervains tenosynovitis predominantly impacts the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) tendons, which pass through the first dorsal compartment of the wrist. The etiology of this disease is due to repetitive and continued strain of the APL and EPB tendons as they pass under a thickened and swollen extensor retinaculum. Patients present with complaints of pain and inflammation in the region of the radial styloid. This pain is exacerbated by motion and activity requiring ulnar deviation with a clenched fist and thumb metacarpophalangeal (MP) joint flexion. Specific activities that may incite complaints include wringing a washcloth, gripping a golf club, lifting a child, or hammering a nail. Inflammation is increased with continued performance of these or similar functional activities. Physical examination may reveal swelling and tenderness in the region of the first dorsal compartment. Finklesteins test, which involves thumb MP joint flexion within a closed fist combined with active or passive wrist ulnar deviation, can result in a painful response over the styloid process of the radius. This is due to a restricted gliding of the APL and EPB tendons in the narrowed compartment caused by a thickening of the extensor retinaculum and the APL and EPB tendons.

• #26 de Quervain’s Tenosynovitis: Causes & Treatment – familydoctor.org

  https://familydoctor.org/condition/de-quervains-tenosynovitis/

  Treatment for de Quervain’s tenosynovitis focuses on reducing pain and swelling. It includes: […] Getting injections of steroids or a local anesthetic (numbing medicine) into the tendon sheath. These injections are very effective and are used regularly. […] De Quervain’s tenosynovitis is a temporary condition. It generally responds well to treatment. It is important to treat de Quervain’s tenosynovitis. If this condition isn’t treated, it can permanently limit your movement or cause the tendon sheath to burst.

• #27

  https://link.springer.com/article/10.1007/s11552-014-9649-3

  Conservative management of de Quervains tenosynovitis differs based on the severity of the condition. Options include anti-inflammatory medication, corticosteroid injections, and occupational therapy (OT). If symptoms persist despite a trial of conservative care, surgical intervention may be warranted. Surgery consists of a release of the first dorsal compartment, including any sub-compartments, followed by immobilization and OT. Specific components of OT include activity modification with patient education, splinting, manual treatment, use of modalities, edema and scar management, as well as desensitization and therapeutic exercises. […] The goal of therapeutic exercises is to enhance gliding of the APL and EPB tendons in the first dorsal compartment. Pain-free active range of motion (AROM) exercise is initiated to the patients tolerance, focusing on the wrist and thumb joints. Tendon gliding of the APL and EPB tendons is gently incorporated into thumb MP flexion combined with wrist ulnar deviation. Strengthening exercises are then initiated to assist in return to functional activity.

• #28 Potential effects, diagnosis, and management of De Quervain Tenosynovitis in the aesthetics community: A Brief Review, Case Example, and Illustrative Exercises | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/management-of-de-quervain-tenosynovitis/

  The estimated prevalence of DQT is about 0.5 percent in men and 1.3 percent in women, with peak prevalence occurring around age 40 to 50 years. The current most widely affected population are new mothers and daycare workers. Often referred to as mommy’s thumb, DQT in this patient population is the result of the strain placed on the thumb in the cylindrical position due to picking and carrying infants and toddlers. Another cause of DQT that has recently become more prevalent is the strain on the thumb from texting and scrolling on smart phones. […] Nonoperative management is the first line of defense against DQT. To avoid surgery, an early onset diagnosis is important for a full recovery from this injury. Conservative treatment methods are primarily used as a starting point when managing DQT. The first step is rest and immobilization. This is often paired with nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation.

• #29 Potential effects, diagnosis, and management of De Quervain Tenosynovitis in the aesthetics community: A Brief Review, Case Example, and Illustrative Exercises | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/management-of-de-quervain-tenosynovitis/

  Once the brace is discontinued, physical therapy (PT) and occupational therapy (OT) will be ordered to help regain strength and proper function to the injured area. The goal of the therapeutic exercises is to enhance and promote gliding of the APL and EPB tendons in the first dorsal compartment. […] Corticosteroid injections are a mainstay of treatment for DQT, with as many as 60 to 90 percent of patients reporting improvement in symptoms after one injection, though studies have differed as to the benefit of adding immobilization after corticosteroid injection. The combined technique of corticosteroid injection and thumb spica casting has shown better results than injection alone in DQT treatment in terms of treatment success and functional outcomes. […] Surgical release of the extensor retinaculum is performed as a treatment for DQT when conservative treatment fails. The goal of surgery is to release the tendon sheath to make room for the irritated tendons. When done correctly, this can relieve DQT symptoms without affecting hand/wrist function.

• #30

  https://link.springer.com/article/10.1007/s11552-014-9649-3

  Although OT treatment in combination with NSAIDs and corticosteroid injections has shown relief of symptoms in de Quervains tenosynovitis, a first dorsal compartment release may be necessary if continued symptoms present. OT treatment methods for de Quervains tenosynovitis assists with the healing of this disease through activity modification with patient education, splinting, manual treatment, use of modalities, edema, and scar management, as well as desensitization and therapeutic exercises.

• #31 De Quervain’s Tenosynovitis: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/orthopedics/columbia-orthopedics/de-quervains-tenosynovitis

  De Quervain’s tenosynovitis causes swelling of the tendons around the base of your thumb, resulting in tenderness and pain along the inside of your wrist. […] In people with de Quervain’s tenosynovitis (also known as de Quervain’s syndrome, de Quervain’s disease, or de Quervain’s tendinosis), the tendons become swollen or the sheath thickens. This puts pressure and friction on the tendons and inhibits their ability to slide smoothly through the sheath, causing inflammation and pain. […] De Quervain’s tenosynovitis most often happens from overuse, when you do too much of a certain type of movement (repetitive stress injury). It may also result from a direct injury to the thumb or rheumatoid arthritis.

• #32 De Quervain’s tenosynovitis – Pathway

  https://www.pathway.md/diseases/de-quervains-tenosynovitis-recrOHsqFe4H42fIs

  De Quervain’s tenosynovitis is a tendon entrapment condition involving the abductor pollicis longus and extensor pollicis brevis tendons, which become restricted within the first dorsal compartment. […] The etiology and pathogenesis of de Quervain’s tenosynovitis are unknown, though repetitive movements and overuse have been proposed as contributing factors. Non-inflammatory thickening of the tendons and swelling of the tendon sheaths leads to impaired gliding of the tendons through the first dorsal compartment. […] Consider offering surgery to reduce the mechanical friction between the roof of the first compartment and the abductor pollicis longus and the extensor pollicis brevis by surgically opening the compartment in order to reduce the symptoms of de Quervain’s tenosynovitis.

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