டி குவெர்வேனின் டெனோசினோவிடிஸ்

Overview

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• Extensor retinaculum reconstruction procedures can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients [12].
• The effectiveness of each additional corticosteroid injection for de Quervain tenosynovitis in diabetic patients does not appear to diminish [12].
• Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [13].
• The success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections [15].
• Repeat injections for De Quervain's tenosynovitis have a high rate of success and are a viable clinical option [15].
• The scientific literature on the surgical and nonsurgical management of de Quervain tendinopathy is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials [16].
• Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery compared with open release [21].
• Endoscopic release for de Quervain's tenosynovitis results in fewer superficial radial nerve complications compared with open release [21].
• Endoscopic release for de Quervain's tenosynovitis results in greater scar satisfaction compared with open release [21].
• Patients who scored lower than 40 for physical function had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [26].
• Patients who scored higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [26].

Anatomy & Pathophysiology

• Extensor retinaculum reconstruction can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5].
• Diagnostic maneuvers for de Quervain tenosynovitis that produce pain in a location other than the radial styloid suggest the need for advanced imaging to identify other anatomic causes [6].
• The tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis [10].
• The tethered thumb maneuver can support the diagnosis of de Quervain tenosynovitis [10].
• The tethered thumb maneuver can assist in determining an effective treatment algorithm for de Quervain tenosynovitis [10].
• MRI is the imaging modality with the greatest ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity [27].
• Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare [28].
• Screw penetration greater than 1.5 mm in the third and fourth extensor compartments is likely to cause problems [45].
• The flexor carpi radialis brevis muscle can become clinically symptomatic when its tendon intersects with the flexor carpi radialis tendon [47].
• Intersection of the flexor carpi radialis brevis tendon with the flexor carpi radialis tendon can cause localized tendinosis and tenosynovitis [47].
• Anomalous muscles such as the flexor carpi radialis brevis should be included in the differential diagnosis of radial side wrist pain [50].
• Extensor indicis proprius syndrome is characterized by dorsal wrist pain [51].
• Extensor indicis proprius syndrome is characterized by synovitis within the fourth dorsal compartment [51].
• In distal radial fractures treated with volar locking plates, ultrasonography can determine increases in the thickness of the flexor pollicis longus (FPL) tendon [53].
• In distal radial fractures treated with volar locking plates, ultrasonography can determine a consequent decrease in the distance between the FPL tendon and the plate [53].
• Ultrasonography consistently provided a reliable evaluation of the pertinent first extensor compartment anatomy in a cadaver model [55].
• In a cadaver model, ultrasonography improved the accuracy of needle placement for first extensor compartment injection [55].
• The short axis is more accurate than the long axis for ultrasound measurements of the first extensor compartment [56].

Classification

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• Procedures such as extensor retinaculum reconstruction can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5].
• If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [6].
• De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].
• Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively [8].
• Styloid abnormalities, though considered as a manifestation of de Quervain's disease by some authors, do not affect the outcome of management [9].
• The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [10].
• In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [17].
• Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role [25].
• The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis [33].
• Quality information about De Quervain's tendinitis is available on the internet and is most likely to be found using the search term De Quervain's tenosynovitis and in the first 10 results of an internet search [37].

Clinical Presentation

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• Procedures for extensor retinaculum reconstruction can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5].
• If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [6].
• De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].
• Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity [8].
• Once diagnosed, post-traumatic de Quervain's syndrome is typically successfully treated non-operatively [8].
• Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9].
• The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [10].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11].
• More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis [14].
• In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [17].
• No relationship was established between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].
• The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [19].
• Clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome [20].
• Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of de Quervain tenosynovitis [23].
• The combined use of corticosteroid injection and hand therapy intervention decreases pain and symptomology as measured through provocative testing in patients with de Quervain's [30].
• The strength of the evidence supporting the combined use of corticosteroid injection and hand therapy intervention is limited [30].
• A staged version of the Finkelstein test is reliable, easy, and reproducible for diagnosing de Quervain's tendonitis while causing minimal discomfort compared to traditional descriptions [31].

Investigations

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [6].
• De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].
• Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively [8].
• Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9].
• The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [10].
• In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [17].
• No relationship was established between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].
• The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [19].
• Clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome, as a causative link between trauma and the syndrome was not demonstrated in the original report [20].
• Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of de Quervain tenosynovitis [23].
• Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role [25].
• No other imaging modality can compete with MRI's ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity [27].
• Growth hormone abuse is associated with a more recalcitrant form of de Quervain tenosynovitis that does not respond well to nonsurgical treatment, thus leading to increased likelihood of surgical decompression [42].
• Tenosynovitis with psammomatous calcification must be differentiated from intra-articular lesions, particularly in atypical presentations [43].

Treatment

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• Extensor retinaculum reconstruction using the wide-awake approach can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis [5].
• Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively [8].
• Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish [12].
• Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [13].
• More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis [14].
• Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option [15].
• The scientific literature on the surgical and nonsurgical management of de Quervain tendinopathy is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials [16].
• Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [21].
• One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo [22].
• Nonoperative options are commonly used as first-line treatment for tenosynovitis of the hand and wrist, but questions remain regarding when to advance to operative intervention [24].
• A single cortisone injection was effective in alleviating symptoms of de Quervain tendinopathy in 82% of patients, with over half remaining symptom-free for at least 12 months [32].
• The combined technique of corticosteroid injection and thumb spica casting was better than injection alone in the treatment of de Quervain tenosynovitis in terms of treatment success and functional outcomes [34].
• Iontophoresis with dexamethasone may improve functional outcomes in patients with de Quervain's tenosynovitis [35].
• Therapeutic pulsed ultrasound may be effective in decreasing pain in patients with de Quervain's tenosynovitis [36].
• First dorsal compartment release during volar approach for distal radius fracture fixation reduces symptoms in patients with pre-existing De Quervain disease [38].

Complications

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [6].
• De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].
• Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively [8].
• Styloid abnormalities do not affect the outcome of management in de Quervain's disease [9].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients [12].
• The effectiveness of each additional corticosteroid injection for de Quervain tenosynovitis in diabetic patients does not appear to diminish [12].
• Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [13].
• More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis [14].
• No relationship was established between rheumatoid tenosynovitis and de Quervain's disease or snapping-finger [18].
• The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome [19].
• Clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome [20].
• One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo [22].
• Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis [39].
• Risk factors for de Quervain's include female gender, age greater than 40, and black race [40].

Recovery

• Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases [1].
• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [2].
• Injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [3].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [4].
• De Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma [7].
• The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm [10].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [11].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients [12].
• The effectiveness of each additional corticosteroid injection for de Quervain tenosynovitis in diabetic patients does not appear to diminish [12].
• Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [13].
• More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis [14].
• Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option [15].
• The scientific literature on the surgical and nonsurgical management of de Quervain tendinopathy is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials [16].
• Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [21].
• Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [26].
• Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare [28].
• The tendoscopic technique for de Quervain's disease could provide earlier symptom relief and earlier recovery with fewer complications and more desirable scar, as well as equivalent successful long-term outcome, when compared with traditional open release technique [41].
• Only 34.9% of patients with new stenosing tenosynovitis required surgery within a 2-year follow-up period [44].
• Most patients with new stenosing tenosynovitis progress to surgery within 1 year of presentation [44].

Key Evidence

• [L4] Triggering due to de Quervain tenosynovitis is a rare condition where surgical release is required in most cases. [1] (10.1016/j.jhsg.2022.04.004)
• [L4] Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management. [2] (10.1016/j.jhsg.2024.01.009)
• [L4] According to the limited evidence available, injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment. [3] (10.1016/j.jhsa.2008.12.030)
• [L3] Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values. [4] (10.1097/corr.0000000000001577)
• [L4] These procedures can be broadly applied without specialized equipment for optimizing function in de Quervain tenosynovitis. [5] (10.1016/j.jhsa.2017.07.024)
• [L4] If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain. [6] (10.1016/j.jhsa.2014.09.024)
• [L4] The results suggest that de Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma. [7] (10.1177/1758998315599796)
• [L4] Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively. [8] (10.1177/1753193416646722)
• [L4] Though considered as a manifestation of de Quervain's disease by some authors, styloid abnormalities do not affect the outcome of management as proved in this study. [9] (10.1007/s11552-010-9258-8)
• [L4] The proposed tethered thumb maneuver elicits a characteristic response in many patients with de Quervain tenosynovitis and can support the diagnosis and assist in determining an effective treatment algorithm. [10] (10.1016/j.jhsa.2013.04.017)
• [L3] This study indicates that corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. [11] (10.1177/1558944716681976)
• [L4] Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish. [12] (10.1016/j.jhsa.2022.02.018)
• [L1] Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis. [13] (10.1016/j.jhsa.2024.03.003)
• [L3] More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis. [14] (10.1097/corr.0000000000000992)
• [L2] Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option. [15] (10.1016/j.jhsa.2021.04.018)
• [L4] The scientific literature on the surgical and nonsurgical management of de Quervain tendinopathy is sparse and limited largely to uncontrolled cohorts with low-quality randomized trials. [16] (10.1016/j.jhsa.2013.06.003)
• [L4] In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised. [17] (10.2106/00004623-194931040-00019)
• [L4] The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome. [19] (10.1177/17531934231214137)
• [Letter] The letter argues that the original report failed to demonstrate a causative link between trauma and de Quervain's syndrome, suggesting clinicians should be aware that persistent radial wrist pain following injury may be due to de Quervain's syndrome. [20] (10.1177/1753193417726668)
• [L1] Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release. [21] (10.1302/0301-620x.95b7.31486)
• [L1] One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo. [22] (10.1186/1471-2474-10-131)
• [L3] Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of de Quervain tenosynovitis. [23] (10.1016/j.jhsg.2025.100778)
• [L4] Nonoperative options are commonly used as first-line treatment for tenosynovitis of the hand and wrist, but questions remain regarding when to advance to operative intervention. [24] (10.2106/jbjs.rvw.o.00061)
• [L4] Septation of the first extensor compartment is more common in patients with de Quervain disease than in the general population, suggesting this anatomical variation may play an etiological role. [25] (10.2106/00004623-198668060-00016)
• [L4] Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis. [26] (10.1016/j.jhsa.2023.07.005)
• [L4] No other imaging modality can compete with MRI's ability to visualize the vast number of pathological conditions that can cause pain in the upper extremity. [27] (10.1197/j.jht.2007.04.001)
• [L4] Stiffness of the proximal interphalangeal joints secondary to tenosynovitis is rare. [28] (10.2106/00004623-197658060-00010)
• [L1] The paper supports the combined use of corticosteroid injection and hand therapy intervention to decrease pain and symptomology as measured through provocative testing in patients with de Quervain's, though the strength of the evidence is limited. [30] (10.1016/j.jht.2015.12.004)
• [L4] The authors describe a staged version of the Finkelstein test that is reliable, easy, and reproducible for diagnosing de Quervain's tendonitis while causing minimal discomfort compared to traditional descriptions. [31] (10.1016/j.jhsa.2010.05.022)
• [L4] A single cortisone injection was effective in alleviating symptoms of de Quervain tendinopathy in 82% of patients, with over half remaining symptom-free for at least 12 months. [32] (10.1016/j.jhsa.2014.12.027)
• [L3] The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis. [33] (10.1177/1558944718810864)
• [L2] The combined technique of corticosteroid injection and thumb spica casting was better than injection alone in the treatment of de Quervain tenosynovitis in terms of treatment success and functional outcomes. [34] (10.1016/j.jhsa.2013.10.013)
• [L4] This study demonstrated that iontophoresis with dexamethasone may improve functional outcomes, while therapeutic pulsed ultrasound may be effective in decreasing pain in patients with de Quervain's tenosynovitis. [35] (10.1016/j.jht.2014.08.033)
• [L4] This study demonstrated that iontophoresis with dexamethasone may improve functional outcomes, while therapeutic pulsed ultrasound may be effective in decreasing pain in patients with de Quervain's tenosynovitis. [36] (10.1016/j.jht.2014.08.032)
• [L4] Quality information about De Quervain's tendinitis is available on the internet and is most likely to be found using the search term De Quervain's tenosynovitis and in the first 10 results of an internet search. [37] (10.1007/s11552-014-9657-3)
• [L1] The current results demonstrated a significantly greater reduction in de Quervain disease symptoms in the release group compared with the no release group during the short-term follow-up. [38] (10.1016/j.jhsg.2024.03.009)
• [L3] Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis. [39] (10.1186/s12891-015-0579-1)
• [L2] Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race. [40] (10.1016/j.jhsa.2008.08.020)
• [L3] The results of this study suggest that tendoscopic technique for de Quervain's disease could provide earlier symptom relief and earlier recovery with fewer complications and more desirable scar, as well as equivalent successful long-term outcome, when compared with traditional open release technique. [41] (10.1186/s13018-019-1393-5)
• [L3] Our results suggest that growth hormone abuse is associated with a more recalcitrant form of de Quervain tenosynovitis that does not respond well to nonsurgical treatment, thus leading to increased likelihood of surgical decompression. [42] (10.1177/0363546509337993)
• [Case_report] This case highlights the importance of differentiating tenosynovitis with psammomatous calcification from intra-articular lesions, particularly in atypical presentations, and demonstrates the effectiveness of surgical intervention in resolving symptoms. [43] (10.1016/j.jhsg.2023.08.001)
• [L2] Only 34.9% of patients with new stenosing tenosynovitis required surgery within a 2-year follow-up period, with most progressing to surgery within 1 year of presentation. [44] (10.1016/j.jhsa.2017.06.088)
• [L4] The study suggests that screw penetration greater than 1.5 mm in the third and fourth extensor compartments is likely to cause problems. [45] (10.1177/1753193410392869)
• [Case_report] The flexor carpi radialis brevis muscle can become clinically symptomatic when its tendon intersects with the flexor carpi radialis tendon, causing localized tendinosis and tenosynovitis. [47] (10.1016/j.jhsa.2008.06.014)
• [Case_report] Anomalous muscles such as the flexor carpi radialis brevis should be included in the differential diagnosis of radial side wrist pain. [50] (10.1016/j.jhsa.2009.12.028)
• [L4] The extensor indicis proprius syndrome is characterized by dorsal wrist pain and synovitis within the fourth dorsal compartment. [51] (10.2106/00004623-196951080-00016)
• [L4] In distal radial fractures treated with volar locking plates, increases in the thickness of the FPL tendon and a consequent decrease in the distance between the tendon and the plate can be determined with ultrasonography. [53] (10.1016/j.jhsa.2015.11.022)
• [L5] Ultrasonography consistently provided a reliable evaluation of the pertinent first extensor compartment anatomy and, in this cadaver model, improved the accuracy of needle placement for first extensor compartment injection. [55] (10.5435/jaaos-d-15-00753)
• [L5] The results support the idea that the short axis is more accurate than the long axis. [56] (10.1177/1558944719873435)

References

[1] Triggering Thumb Is Not Always a Trigger Thumb. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.04.004 [2] De Quervain’s Tenosynovitis: As Seen from the Perspective of the Patient. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.01.009 [3] Nonsurgical Treatment for de Quervain's Tenosynovitis. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.030 [4] Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001577 [5] Extensor Retinaculum Reconstruction Using the Wide-Awake Approach. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.07.024 [6] Longitudinal Split Tear of the Extensor Pollicis Brevis Tendon: Report of 2 Cases. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.09.024 [7] De Quervain’s syndrome: It may not be an isolated pathology. Hand Therapy. 2015. DOI: 10.1177/1758998315599796 [8] Post-traumatic de Quervain’s syndrome: a rare condition, often diagnosed late. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416646722 [9] Does Radial Styloid Abnormality in de Quervain's Disease Affect the Outcome of Management?. HAND. 2010. DOI: 10.1007/s11552-010-9258-8 [10] Tethered Thumb Sign: A Unique Observation in the Physical Examination of de Quervain Tenosynovitis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.04.017 [11] Effectiveness of Corticosteroid Injections for Treatment of de Quervain’s Tenosynovitis. HAND. 2016. DOI: 10.1177/1558944716681976 [12] Effectiveness of Corticosteroid Injections in Diabetic Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2022.02.018 [13] Advancements in de Quervain Tenosynovitis Management: A Comprehensive Network Meta-Analysis. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.003 [14] Which Psychological Variables Are Associated With Pain and Function Before Surgery for de Quervain’s Tenosynovitis? A Cross-sectional Study. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000992 [15] De Quervain Tenosynovitis: An Evaluation of the Epidemiology and Utility of Multiple Injections Using a National Database. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2021.04.018 [16] Current Treatment of de Quervain Tendinopathy. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.06.003 [17] AN UNUSUAL FORM OF DE QUERVAINʼS SYNDROME. The Journal of Bone & Joint Surgery. 1949. DOI: 10.2106/00004623-194931040-00019 [18] Rheumatoid Tenosynovitis: Diagnosis and Treatment.. The Journal of Bone and Joint Surgery. American Volume. 1958. [19] Prediction of an intracompartmental septum and its effect on outcomes of endoscopic release for de Quervain’s syndrome. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231214137 [20] Letter and reply. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417726668 [21] Endoscopicversusopen release in patients with de Quervain’s tenosynovitis. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b7.31486 [22] Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice. BMC Musculoskeletal Disorders. 2009. DOI: 10.1186/1471-2474-10-131 [23] Incidence and Risk Factors for Soft Tissue Hand and Wrist Conditions in Pregnancy and Postpartum. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100778 [24] Tenosynovitis of the Hand and Wrist. JBJS Reviews. 2016. DOI: 10.2106/jbjs.rvw.o.00061 [25] Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study.. The Journal of Bone & Joint Surgery. 1986. DOI: 10.2106/00004623-198668060-00016 [26] Association of Patient-Reported Outcomes Measurement Information System Measures With Injection and Surgical Treatment Response in Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.07.005 [27] Case Studies in the Diagnosis of Upper Extremity Pain Using Magnetic Resonance Imaging. Journal of Hand Therapy. 2007. DOI: 10.1197/j.jht.2007.04.001 [28] Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis. The Journal of Bone & Joint Surgery. 1976. DOI: 10.2106/00004623-197658060-00010 [30] Clinical Relevance Commentary on: Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: A systematic review and meta-analysis. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2015.12.004 [31] Staged Description of the Finkelstein Test. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.05.022 [32] de Quervain Tendinopathy: Survivorship and Prognostic Indicators of Recurrence Following A Single Corticosteroid Injection. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.12.027 [33] Prevalence of a Septated First Dorsal Compartment Among Patients With and Without De Quervain Tenosynovitis: An In Vivo Anatomical Study. HAND. 2018. DOI: 10.1177/1558944718810864 [34] Corticosteroid Injection With or Without Thumb Spica Cast for de Quervain Tenosynovitis. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.10.013 [35] The Upper Limb Functional Index (ULFI) – A Review of Published Validation Studies Show Improved Clinimetric Properties and Recommends a Simple Format Change. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2014.08.033 [36] Effective Conservative Treatments for De Quervain's Tenosynovitis: A Retrospective Study. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2014.08.032 [37] The Internet as a Source of Information for De Quervain's Tendinitis. HAND. 2014. DOI: 10.1007/s11552-014-9657-3 [38] First Dorsal Compartment Release During Volar Approach for Distal Radius Fracture Fixation Reduces Symptoms in Patients With Pre-Existing De Quervain Disease. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.009 [39] Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data. BMC Musculoskeletal Disorders. 2015. DOI: 10.1186/s12891-015-0579-1 [40] Incidence of de Quervain's Tenosynovitis in a Young, Active Population. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.08.020 [41] Tendoscopic versus open release for de Quervain’s disease: earlier recovery with 7.21 year follow-up. Journal of Orthopaedic Surgery and Research. 2019. DOI: 10.1186/s13018-019-1393-5 [42] Abuse of Growth Hormone Increases the Risk of Persistent de Quervain Tenosynovitis. The American Journal of Sports Medicine. 2009. DOI: 10.1177/0363546509337993 [43] Tenosynovitis With Psammomatous Calcification Preoperatively Diagnosed as Intra-Articular Free Body of the Young Male Wrist: A Case Report. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2023.08.001 [44] A Prospective Study of Risk Modeling for Stenosing Tenosynovitis. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.088 [45] Screw prominences related to palmar locking plating of distal radius. Journal of Hand Surgery (European Volume). 2011. DOI: 10.1177/1753193410392869 [47] Flexor Carpi Radialis Brevis Muscle Presenting as a Painful Forearm Mass: Case Report. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.06.014 [50] Symptomatic Flexor Carpi Radialis Brevis: Case Report. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.12.028 [51] The Extensor Indicis Proprius Syndrome. The Journal of Bone & Joint Surgery. 1969. DOI: 10.2106/00004623-196951080-00016 [53] Ultrasonic Evaluation of the Flexor Pollicis Longus Tendon Following Volar Plate Fixation for Distal Radius Fractures. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.11.022 [55] Ultrasonography-guided de Quervain Injection. Journal of the American Academy of Orthopaedic Surgeons. 2016. DOI: 10.5435/jaaos-d-15-00753 [56] Ultrasound Measurements of the First Extensor Compartment: Determining the Transection Limits for Ultra-minimally Invasive Release of De Quervain Tenosynovitis. HAND. 2019. DOI: 10.1177/1558944719873435