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DeQuervain's Tenosynovitis Cheat Sheet (DRAFT) by

Management presentation etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.


- Inflam­mation of tendons and synovial sheaths of APL and EPB


- Repetitive friction
- Microt­rauma
- Lifting, grasping and pinching with wrist radial or ulnar deviation (causes tendons to rub against radial styloid process)
- Gardening, knitting, cooking, playing a musical instru­ment, carpentry, walking a pet, texting, video gaming, sports (golf, volley­ball, fly fishing, racquet sports, excessive mobile use
- Lifting childr­en/­babies
- Diabetes
- RA
- Pregnancy (changes in oestrogen)
- Women more than men
- Black people affected more than other races
- Extra defect - intrac­omp­art­mental septum


- Pain lateral aspect of wrist but can move towards brachi­ora­dialis
- Pain may begin gradua­lly­/ab­ruptly
- Pain aggravated by movements of the thumb/hand (forceful pinchi­ng/­gra­spi­ng/­twi­sting)
- Swelling over EPB and APL tendons
- "­Squ­eak­ing­" sound with movement of the wrist
- Catchi­ng/­sna­pping can occur
- Numbness over dorsal thumb and index finger
- Tenderness over first dorsal compar­tment (radial styloid process)
- Decreased ROM of thumb (resisted thumb extension painful)
- Diminished pinch grip (Determine from CTS)
- +ve Finkel­steins
- If intrac­omp­art­mental septum +ve EPB entrapment test


- Ultrasound
- MRI only if red flags are present (Hx of trauma, systemic signs, failed conser­vative care)


- Inters­ection syndrome
- OA of the 1st CMC
- Thumb sprain
- Ganglion cyst
- Distal radial nerve entrapment
- Cervical Radicu­lopathy


- US
- Laser
- Cryoth­erapy
- Rest (avoid activities that provoke pain, take frequent breaks)
- Splinting?
- Stretching of APL, EPB, wrist flexors, extensors, brachi­ora­dialis
- Myofascial release of first dorsal compar­tment, wrist extensors, brachi­ora­dialis
- SMT of wrist, Cx
Poor prognosis factors: Pain score >8/10, involv­ement of sensory branch of the radial nerve, inability to tolerate NSAIDs, inabil­ity­/un­wil­ligness to perform home therapy and implement changes in ADLs, Severe swelling over 1st dorsal compar­tment, presence of intrac­omp­art­mental septum
- Surgery if conser­vative treatment or injection fails