De Quervain's disease

De Quervain’s disease is a stenosing tenosynovitis of the extensor tendons of the first dorsal compartment, namely extensor pollicis brevis (marked as A) and abductor pollicis longus (marked as B). It is prominent among females, especially women of childbearing age.

Clinical features of De Quervain’s disease include visible swelling over the radial styloid, palpable thickening of the tendon sheath, tenderness at the tip of the radial styloid, and pain on resisted thumb extension (hitch-hiker’s sign).

To perform Finkelstein’s test, the examiner securely holds the patient’s hand with the (patient’s) thumb tucked into their (examiner’s) palm. The examiner proceeds to rotate the patient’s wrist fully towards the ulnar side (ulnar deviation). If the test result is positive, this maneuver will cause sharp pain in the affected sheath.

To perform Eichhoff’s test, the individual is instructed to place her thumb inside their hand and make a firm grip by closing the other fingers. The examiner would then gently move the hand towards the ulnar side (away from the midline) in an outward direction. If sharp pain occurs along the distal radius, De Quervain’s tenosynovitis is suspected.

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