Case study: De Quervain’s tenosynovitis

A 56-year-old lady presents with a history of chronic pain in her left hand for six months. She has worked in a printing press for the last 6 years. No history of hand injury. 

Physical examination

• Finkelstein test: Positive

Ultrasound findings

Ultrasound of the extensor compartment 1 showed swollen tendons and a surrounding thin rim of inflammatory fluid. 

Transverse view of extensor compartment 1 showing a surrounding thin rim of inflammatory fluid. APL, abductor pollicis longus; EPB, extensor pollicis brevis.

Longitudinal view of extensor compartment 1 showing swollen tendons and a surrounding thin rim of inflammatory fluid. APL, abductor pollicis longus; EPB, extensor pollicis brevis.

Diagnosis

The patient was diagnosed with de Quervain’s tenosynovitis, which is characterized by swelling of the tendons that run along the thumb side of the wrist and attach to the base of the thumb (abductor pollicis longus and extensor pollicus brevis). This occurs when the tendons are constricted by the sheath they run through from the wrist to the hand. 

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