Dr. Carl B. Weiss, an orthopaedic surgeon, answers your questions about de Quervain’s Tenosynovitis.
Q: What is de Quervain’s Tenosynovitis?
A: De Quervain’s Tenosynovitis is a condition caused by entrapment of some of the tendons going to your thumb. These tendons, called the abductor pollicis longus and the extensor pollicis brevis, go through a snug tunnel at the wrist, called the first dorsal extensor compartment. You can see the tendons on the back of your hand when you straighten your fingers. When, for whatever reason, the tunnel becomes too tight, it sets up a vicious cycle; whenever you move your thumb in certain ways, it pulls the tendons through the tight tunnel, causing pain and further aggravating the condition.
Q: How is the diagnosis made?
A: A hand surgeon can help determine if you have de Quervain’s. If you have tenderness over the tendons and pain when you make a fist with your thumb tucked inside and bend the wrist with the pinkie facing down (see image), then you have what is known as a positive Finkelstein’s sign, which would indicate that you likely have de Quervain’s. However, there are other causes of pain in this area, such as arthritis in the joint at the base of your thumb, which can feel similar to de Quervain’s. Therefore, x-rays may be used to help make the diagnosis. A hand surgeon can distinguish between these conditions, though it is quite possible that a patient has both.
