De Quervain’s Tenosynovitis is an inflammation of two tendons (abductor pollicis longus (APL) and extensor pollicis brevis (EPB)) which pass through a tunnel on the external side of the wrist.

The inflammation causes the tendons to increase in volume but the tunnel doesn’t stretch to accommodate this.

De Quervain’s Tenosynovitis: symptoms and diagnosis

A sharp pain is felt when turning or tilting the wrist, or when the thumb column is extended.
It is often accompanied by swelling and a cyst.

More common in women, this condition is often related to professional activity and occurs after giving birth.

X-ray results will be normal but a scan may show a thickening of the tendons, inflammation and the presence of liquid.

De Quervain’s Tenosynovitis: treatment and progression

Medical treatment

The treatment of De Quervain’s Tenosynovitis always requires anti-inflammatories, immobilisation of the wrist and the thumb column with a splint, as well as corticosteroid injections.

Surgery

If medical treatment doesn’t work, surgery may be envisaged. A one-centimetre incision is made along the thumb side of the wrist. This opens up the tunnel and releases the tendons.

The results of surgery are generally favourable, but rarely immediate.

A gradual return to work is recommended, with time off work varying between three and six weeks depending on the patient’s profession.

Complications relate to those occurring in hand surgery in general. The sensory branches of the radial nerve may suffer from irritation but this often fades in time. However, injury to these branches may lead to permanent after-effects. An anterior subluxation of the tendons when the wrist is flexed may also occur.