De quervains tenosynovitis

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De quervains tenosynovitis

  1. 1. MSN 7702 Tamieka Bugam Rebecca Poole DeQuervains Tenosynovitis
  2. 2. • In 1895, a Swiss surgeon, Fritz de Quervain, published 5 case reports of patients with a tender, thickened first dorsal compartment at the wrist. The condition has subsequently borne his name, De Quervain tenosynovitis. • (Medscape, 2013) What is DeQuervains Tenosynovitis?
  3. 3. • De Quervain's Tenosynovitis occurs when tendons on the thumb side of the wrist are swollen or irritated. The irritation causes the lining (synovium) around the tendon to swell, which changes the shape of the compartment. De Quervain tenosynovitis is an entrapment tendinitis of the tendons contained within the first dorsal compartment at the wrist; it causes pain during thumb motion. • DeQuervains Tenosynovitis may be caused by overuse. It can be seen in association with pregnancy. It may be found in inflammatory arthritis, such as rheumatoid disease. This condition is usually most common in middle-aged women. • (American Academy of Orthopedic Surgeons, 2013) Causes of DeQuervains Tenosynovitis
  4. 4. Frequency Mortality/Morbidity Race Sex Age Most prevalent among individuals who perform repetitive activities using their hands. For example, certai n assembly line workers and secretaries Mortality is not associated with de Quervain tenosynovitis. Some morbidity may result as the patient experiences progressive pain, with limitations occurring in activities requiring use of the affected hand. No race predilection has been reported for de Quervain tenosynovitis The incidence of de Quervain tenosynovitis appears to be significantly greater in women 8:1 ratio Seen in Adults more than children. However as discussed in lecture, these conditions are increasing in younger populations. • (Medscape, 2013) Epidemiology
  5. 5. Diagnosis- Finkelstein’s Test
  6. 6. • 1Instruct the patient to sit on an examination table or in an elevated chair. He or she should be as comfortable and relaxed as possible. • 2Have the patient hold the afflicted hand in the air. The other arm should be resting against his or her body. • 3Grasp the patient's hand and rotate it toward the outside of the forearm, a position known as ulnar deviation. The wrist won't move very much, so don't force it beyond 20 degrees of flexion. • 4Pull the patient's thumb across the palm of his or her hand. This places tension on the extensor tendons of the thumb. • 5Ask the patient if he or she feels pain radiating up the inside of his or her arm from the thumb. If the patient reports noticeable pain, the Finkelstein's Test is positive, and De Quervain syndrome is present (eHow, 2013) Instructions on how to perform the Finkelstein Test
  7. 7. How is De Quervain's tenosynovitis treated?
  8. 8. • Excellent. The patient can generally return to full function after the inflammation quiets down with treatment. Sometimes bracing is used during future activities that involve repetitive wrist motion. What is the outlook (prognosis) with De Quervain's tenosynovitis?
  9. 9. • American Academy of Orthopedic Surgeons (2013). DeQuervains tenosynovitis. Retrieved on October 2, 2013 from http://orthoinfo.aaos.org/topic.cfm?topic=a00007 • Medscape. (2013). DeQuervains tenosynovitis. Retrieved on October 2, 2013 from http://emedicine.medscape.com/article/1243387-overview • The Pain Source (2011, December 15). Finkelstein’s test.*YouTube video+. Retrieved on October 2, 2013 from http://www.youtube.com/watch?v=eL2Uzfd26SA • eHow.(2013). How to perform finkelstein’s test of the hand. Retrieved October 2, 2013 fromhttp://www.ehow.com/how_2212413_perform- finkelsteins-test-hand.html#ixzz2gcMtg9oG References

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