Management of de Quervain Tenosynovitis

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Abstract
De Quervain tenosynovitis (DQT) is a stenosing overuse condition of the synovial sheath of the first extensor compartment of the wrist affecting the extensor pollicis brevis (EPB) and abductor pollicis longus tendons.1 The exact pathophysiology of DQT is unknown, but it appears to be related to thickening of the tendon sheath and the overlying extensor retinaculum, as well as thinning and degeneration of the affected tendons.2 Involvement of inflammation remains controversial but intrinsic degeneration due to overuse appears to be the most likely mechanism.3 Possible associations have been made between a separate, septated EPB subcompartment and DQT; however, increasing evidence suggests that this is probably a normal anatomical variant.4 DQT manifests with pain and tenderness over and proximal to the radial styloid, and while its diagnosis is predominantly clinical, imaging modalities, such as ultrasonography and magnetic resonance imaging, can be useful where there is diagnostic uncertainty.1

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