De Quervain’s Tenovaginitis of the first extensor compartment of the wrist is a common problem in adults of various ages and mostly has an insidious onset without any predisposing factors. Patients usually complain of severe pain over the thumb-side of the wrist, which is exacerbated when the thumb is gripped in the palm and the wrist is flexed laterally towards the small finger -side.
De Quervain’s Tenovaginitis is usually adequately diagnosed with clinical provocative testing and local anaesthetic injection. Sometimes, when there is doubt as to wether arthritis of the basal joint of the thumb may be contributing, X-rays, ultrasound scanning or rarely MRI scan may be required.
Treatment of De Quervain’s Tenovaginitis initially involves local anaesthetic and steroid injection into the tendon sheath in combination with wrist bracing. If conservative treatment is unsuccessful after two or three injections, surgical decompression of the tendon sheath may be required.
