Transcript Causes of De Quervain`s Tenosynovitis

De Quervain’s Tenosynovitis.
Contents
The definition of De Quervain’s
Tenosynovitis.
 Incidence of De Quervaain’s
Tenosynovitis.
Causes of De Quervain’s Tenosynovitis
Pathophysiology of De Quervain’s
Tenosynovitis .
Sign Symptoms of De Quervain’s
Tenosynovitis.
Diagnosis.
Management of De Quervain’s
Tenosynovitis.
Prognosis.
De Quervain’s Tenosynovitis
De Quervain's tenosynovitis is an inflammation
of the sheaths of the tendons that move the
thumb up and out (at the base of the thumb ).
These tendons include-
The extensor pollicis brevis and
The abductor pollicis longus tendons.
Figure: Area of De Quervain’s Tenosynovitis.
Incidence
Between the ages of 30 and 50.
Women are afflicted with 8 to 10
times more often than men.
People who engage in repetitive
activities as in hammering, skiing,
etc, may predispose to developing
this disorder.
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Causes of De Quervain’s
Tenosynovitis:
Overuse of the thumb and wrist.
It can occur as a result of an acute injury to
the involved area (direct blow to the forearm
or wrist, falling on the thumb).
It can also be seen in association with
inflammatory arthritis such as rheumatoid
arthritis.
Patho physiology:
Increased vascularization of the outer
sheath with edema.
Increases the thickness of the sheath.
Constricting the existing tendon.
Microadhesions may form between
the sheath and the tendon.
Sheath thickness two to four times its normal size.
Signs and Symptoms:
Gradual onset of pain over the area and
increase over time.
Swelling near the base of the thumb.
Numbness in the back of the thumb and
index finger.
Difficulty in moving the thumb and wrist
when grasping or pinching.
Diagnosis:
Special Test:
The Finkelstein Test.
Figure: Finkelstein Test.
Treatment:
Medical management:
Anti-inflammatory drug;
Cortisone injection;
Surgery:
The goal of surgery is to give the tendons more
space so they no longer rub on the inside of the
tunnel. To do this, the surgeon performs a surgical
release of the roof of the tunnel.
Physiotherapy Management:
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Active Range of Motion (AROM);
Passive Range of Motion (PROM);
Cryotherapy or Cold Therapy;
Electrotherapeutic Modalities: Ultra Sound
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Isometric exercises in case of acute cases;
Progressive Resistive Exercises (PRE);
Soft Tissue Mobilization;
Stretching/Flexibility;
Spica Splint.
therapy;
Prognosis:
Excellent prognosis occur. The patient can
generally return to full function after the
inflammation reduce with treatment. Sometimes
bracing is used during future activities that involve
repetitive wrist motion.