Overview
what it is and why it matters
De Quervain's tenosynovitis is inflammation of the first dorsal compartment of the wrist, which contains the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. These tendons run through a tight fibrous tunnel at the radial styloid and swell with repetitive pinching, gripping, or lifting — particularly in new mothers lifting infants (sometimes called "mommy thumb").
The hallmark is pain and tenderness directly over the radial styloid, often with swelling, that worsens with thumb movement and radial deviation of the wrist.
Diagnosis
exam first, imaging secondThe Finkelstein test — wrapping the fingers over the thumb and ulnar-deviating the wrist — reproduces sharp pain at the radial styloid and is the key diagnostic maneuver. Ultrasound can show tendon sheath thickening and confirm the diagnosis while guiding injection. X-rays are taken to exclude radiocarpal arthritis or CMC arthritis.
Treatment Path
how care progresses at OSI1
Thumb spica splinting
Immobilizes the wrist and thumb to allow inflamed tendon sheaths to settle.
2
Activity modification
Avoiding repetitive pinching, lifting with the wrist in ulnar deviation, or repetitive thumb motion.
3
Corticosteroid injection
Injection into the first dorsal compartment — ideally ultrasound-guided — is highly effective and often curative in a single injection.
NSAIDs / ice
Adjuncts for acute pain control.
Surgical Options at OSI
if non-operative care isn't enoughSurgery is offered when two injections have failed or when chronic thickening has narrowed the tunnel irreversibly.
Providers Who Treat De Quervain's Tenosynovitis
sports-medicine team
David B. Templin, M.D.
Trent Twitero, M.D.
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: