Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- location over and around a retinacular sheath
- pain increased with motion
- response to anaesthetic injection
- painful popping sensation with finger flexion and extension (trigger finger)
- palpable nodule at the level of the metacarpal head (trigger finger)
- pain, tenderness, and swelling localised to radial side of wrist (de Quervain's disease)
- pain and swelling proximal to wrist joint (intersection syndrome)
- pain, swelling, tenderness at Lister's tubercle (extensor pollicis longus tenosynovitis)
- ulnar-sided wrist pain (extensor carpi ulnaris tenosynovitis)
- pain at palmar wrist crease over scaphoid tubercle and along length of tendon (flexor carpi radialis tenosynovitis)
Risk factors
- age between fifth and sixth decades
- female sex
- hx of current concomitant conditions with similar pathology (stenosing tendinopathy or neuropathy)
- involvement of dominant hand
- insulin-dependent diabetes
- pregnancy and lactation
- degenerative joint disease or trauma
Diagnostic investigations
Investigations to consider
- plain x-ray of affected hand and wrist
- FBC
- ESR
- CRP
- MRI
- CT scan
Treatment algorithm
Contributors
Authors VIEW ALL
Professor
Department of Orthopaedic Surgery and Rehabilitation
University of Chicago Hospitals
Chicago
IL
Disclosures
JMW receives research funding from the US Department of Defense and American Society for Surgery of the Hand. She receives a salary as deputy editor of Journal of Hand Surgery and updates editor of the textbook Skeletal Trauma.
Dr Jennifer Moriatis Wolf would like to gratefully acknowledge Dr Doug Campbell, Dr Peter Evans, and Dr Shafic Sraj, the previous contributors to this monograph. DC, PE, and SS declare that they have no competing interests.
Peer reviewers VIEW ALL
Assistant Professor of Orthopedic Surgery
Harvard Medical School
Brigham and Women's Hospital
Boston
MA
Disclosures
PEB declares that he has no competing interests.
Director and Head
Department of Plastic, Hand and Reconstructive Microsurgery and Burns
Ganga Hospital
Coimbatore
India
Disclosures
SRS declares that he has no competing interests.
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