This test is mildly painful to most people, but to someone with de Quervain’s stenosing tenosynovitis. Then the patient bends the wrist away from the thumb and towards the little finger side of the hand. In this test, the patient makes a fist with their thumb placed under the fingers. This test is mildly painful to most people, but to someone with de Quervain’s stenosing tenosynovitis.īesides pain and swelling over the first dorsal compartment, having a positive Finkelstein’s test indicates the patient has this problem (Fig. Because of the pain and swelling, there may be some decreased thumb motion.īesides pain and swelling over the first dorsal compartment, having a positive Finkelstein’s test indicates the patient has this problem (Fig. Swelling over the thumb side of the wrist may be present, and some “snapping” when the thumb is moved may occur.

It worsens with the hand and thumb, especially with any forceful grasping, pinching, or twisting. This condition may occur “overnight” or very gradually, radiating pain into the thumb and up the forearm. Pain over the thumb side of the wrist is the primary symptom. People who engage in activities requiring sideways wrist motion while gripping the thumb, like hammering, skiing, and some assembly line jobs, may be predisposed to developing this disorder. Women are afflicted with this condition eight to ten times more often than men. This inflammation may be caused by any condition that changes the shape of the compartment or causes swelling or thickening.ĭe Quervain’s stenosing tenosynovitis occurs most often in individuals between the ages of 30 and 50. A painful cyst may also form in this area because of the increased tissue in the compartment. The lubricating synovial sheath lining this compartment thickens and swells, giving the enclosed tendons less room to move, and producing extra synovial fluid. 2: Anatomy of first dorsal compartment What Is de Quervain’s Stenosing Tenosynovitis?ĭe Quervain’s stenosing tenosynovitis is a painful inflammation of the tendons in the first dorsal compartment of the wrist. 1: Anatomy of six dorsal tendon compartmentsįig.

Both muscles help spread and extend the thumb away from the rest of the hand.įig. Through it passes the tendons for the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) muscles. The first dorsal compartment lies over the bony bump at the base of the thumb (Fig. These tendons run through six lubricated tunnels (compartments) under a thick fibrous layer called the extensor retinaculum. Passing over the back of the wrist are the tendons for muscles that extend or straighten the fingers and thumb and lift the hand at the wrist.

Dorsal wrist compartments