Inflammation of the tendons in the thumb which can be very painful. Conservative treatments include activity modification, modalities, orthotics, and manual therapy. Cellular smears with clustered epithelioid cells, fibrous fragments with enmeshed inflammatory cells, scattered lymphocytes, histiocytes and neutrophils, occasional multinucleated giant cells containing up to 100 nuclei and ingesting colloid or neutrophils. A direct blow to the thumb may also damage the tendon and form scar tissue. This condition is characterized by irritation of the extensor pollicis brevis and abductor pollicis longus, as they pass through their sheaths in the socalled first compartment on the dorsum of the wrist. The swollen tendons and their coverings rub against the narrow tunnel through which they pass. Place your hand on a flat surface, with your palm up.
Inflammation of the sheath of a tendon of the thumb. Once your symptoms are better, work to prevent the condition from happening again. The condition develops when the tendons around the base of. Dequervains tenosynovitis is inflammation of the sheath the synovium. Factors believed to contribute to the onset of this form of tenosynovitis disease include overuse of the wrist linked to occupational 1, 4 or. It is a progressive stenosing tenosynovitis whichaffects the tendon sheaths of the 1st dorsalcompartment of the wrist. For example, lifting a small child, sewing, typing, or playing the piano can cause inflammation. If treatment with steroid injections has failed, surgery should relieve your pain. Characterised by degeneration and thickening ofthe tendon sheath. Download pathology books pdf free january 22, 2018. This scar tissue can keep the tendon from working properly. Pdf the wrist hyperflexion and abduction of the thumb what. Dequervains tenosynovitis inflammation of the tendons of the thumb.
Download pathophysiology of disease an introduction to clinical medicine 8th edition pdf. Dequervains disease musculoskeletal medicine for medical. It is a stenosing tenosynovitis of the abductor pollicis longus apl and extensor pollicis brevis epb tendons fig. It can be caused by overuse of the thumb or wrist which can occur in activities such as knitting, skiing and lifting heavy objects. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. On their way to the thumb, the apl and epb tendons travel side by side along the inside edge of the wrist. There was division with a septum in the extensor compartment in 60%.
If you start treatment early, your symptoms should improve within four to six weeks. Different tests have been described in the past, the most popular test being the eichhoffs. Dequervains pronounced dehkervanes tenosynovitis,also known as dequervains tendinitis and dequervains disease,is a condition that is caused by inflammation of tendons of the thumb at the wrist, characterized by pain and swelling in the thumb and wrist areas. Lift your thumb away from your palm to make a c shape. Diagnostic and therapeutic injection of the wrist and hand region. A presentation, which covers the onset, cause and symptoms of dequervains thyroiditis. This compartment contains the abductor pollicis longus.
The histopathology does not demonstrate inflammation but rather. Feb 25, 2014 a presentation, which covers the onset, cause and symptoms of dequervain s thyroiditis. Download pathophysiology of disease an introduction to. The abductor pollicis longus had more than one tendon in 76% and extensor pollicis brevis was represented by a single tendon in 96%. Between january 2003 and may 2011, 189 patients surgically treated for dq vs. Symptoms may include pain or tenderness when moving the thumb, turning the wrist, grasping something, or making a fist. Extensor pollicis brevis with septation is more effective than manual injection.
There are two main tendons connect muscle to bone that pass through a narrow tunnel on the side of the wrist near the base of the thumb. In the recent years, with few exceptions7,8, a number of textbooks and scientific. Tenosynovitis and synovitis of the first extensor compartment of the. Dequervains tenosynovitis dequervains tenosynovitis. This surrounds the two tendons that are involved in moving the thumb. The first dorsal compartment at the wrist includes the tendons of the abductor pollicis longus apl and the extensor pollicis brevis epb. A prospective casecontrol study was conducted to analyze the most common risk factors for dq. The result is pain that may extend from the forearm to the thumb base. The swollen tendons and their coverings cause friction within the narrow tunnel or sheath through which they pass.
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