CASE STUDY: De Quervain’s tenosynovitis (OTCC 2033)

By jahidjamel25 | Updated: Feb. 23, 2025, 2:25 p.m.

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Jahid DPOT 0012 & Hadif DPOT 0019

SHORT TALK OF CASE STUDY:
De Quervain’s tenosynovitis 
OTCC 2033
Patient background:

Age/gender: 56-year-old woman
Occupation: Worked in a printing press for 6 years
Symptoms: Chronic pain in the left hand for six months
History: No history of hand injury
What Is De Quervain tenosynovitis?
The patient presented with chronic pain localized to the radial aspect of the wrist, which had progressively worsened over the past six months. Her occupational history involving repetitive hand movements suggested a potential overuse injury.
De Quervain tenosynovitis :

Generally, it is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain tenosynovitis, you will probably feel pain when you turn your wrist, grasp anything or make a fist.
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Abductor Pollicis Longus (APL) 
Extensor Pollicis Brevis (EPB)
 These two tendons run along the radial side of the wrist and are part of the first extensor compartment.

They are commonly involved in De Quervain's tenosynovitis
Causes of 
De Quervain's tenosynovitis

Etiology
Repetitive Motion & Overuse
Tendon Irritation of the APL and EPB tendons
Inflammatory arthritis, such as rheumatoid arthritis.
Hormonal Changes
Direct Trauma
Age
Gender
Pregnancy
Occupational Factors
Arthritic Conditions
Risk Factors of 
De Quervain's tenosynovitis
SYMPTOM AND SIGNS
Pain & Tenderness
Difficulty Moving The Thumb
Weakness
Swelling
Pain that Radiates
Sticking or Popping sensation
DIAGNOSIS
There are several types of ways to diagnose De Quervain's tenosynovitis, including Physical Examination, Imaging and Finkelstein's Test.
However, based on this case study, the patient was diagnosed using Finkelstein's Test
The patient makes a fist with the thumb tucked inside the fingers.
The wrist is then bent toward the little finger (ulnar deviation).
If this movement causes sharp pain along the thumb side of the wrist, it suggests De Quervain’s tenosynovitis.
DIAGNOSIS
 Finkelstein’s Test
DIFFERENTIAL DIAGNOSIS
Intersection Syndrome
Carpometacarpal (CMC) Joint Osteoarthritis
Trigger Thumb
Radial Styloid Fracture
 Rheumatoid Arthritis
TREATMENT
A single steroid injection into the tendon sheath can provide significant pain relief. If pain persists after two injections, surgical treatment may be considered.

Corticosteroid Injections

Treatment used in this case study
OTHER TREATMENT CAN BE USE
Activity Modification & RestSplinting (Thumb Spica Splint)Ice TherapyMedications (NSAIDs)Physical Therapy & Stretching
Conservative (Non-Surgical) Treatment
Surgical release of the first dorsal compartment (tenolysis) may be performed.
Surgical Treatment
Wrist Flexor StretchThumb Extensor StretchStrengthening Exercise
Home Exercises
REFERENCES:
Ss, T., F, F., & M, T. (2014, January 1). Multiple variations of the tendons of the anatomical snuffbox. http://mymedr.afpm.org.my/publications/11960
Nysora. (2024, August 29). Case study: De Quervain’s tenosynovitis. NYSORA. https://www.nysora.com/education-news/case-study-de-quervains-tenosynovitis/
Chong, H. H., Pradhan, A., Dhingra, M., Liong, W., Hau, M. Y., & Shah, R. (2024). Advancements in de Quervain Tenosynovitis Management: A Comprehensive Network Meta-Analysis. The Journal of Hand Surgery, 49(6), 557–569. https://doi.org/10.1016/j.jhsa.2024.03.003
De Quervain tenosynovitis - Diagnosis and treatment - Mayo Clinic. (n.d.). https://www.mayoclinic.org/diseases-conditions/de-quervain-tenosynovitis/diagnosis-treatment/drc-20371337
That's all from the two of us. ( :
CASE STUDY 
BYYEEEEEEE

CASE STUDY: De Quervain’s tenosynovitis (OTCC 2033)

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