De Quervain’s Tenosynovitis

• De Quervain’s tenosynovitis is a condition where there is swelling and inflammation of the tendon sheaths in the wrist
• Tendons primarily affected in De Quervain’s tenosynovitis

  • Abductor pollicis longus (APL) tendon
  • Extensor pollicis brevis (EPB) tendon
• De Quervain’s tenosynovitis is a type of repetitive strain injury that results in pain on the radial side of the wrist
• One notable cause of bilateral De Quervain’s tenosynovitis is in new parents repetitively lifting newborn babies in a way that stresses the tendons of the thumb
• De Quervain’s tenosynovitis is sometimes referred to as “mummy thumb”
• Abductor pollicis longus


  Acts to abduct the thumb and abduct the wrist. Inserts into the base of the first metacarpal bone
• Extensor pollicis brevis

  Acts to abduct the thumb and abduct the wrist. Inserts into the base of the proximal phalanx of the thumb
• Tendon sheaths

  Formed by connective tissue (synovial membrane) that covers the tendons and is filled with synovial fluid. Help lubricate and protect the movement of the tendons within them
• Extensor retinaculum

  A fibrous band that wraps across the back (dorsal side) of the wrist. APL and EPB pass underneath it. Repetitive movement under the extensor retinaculum results in inflammation and swelling of the tendon sheaths
• Presentation of De Quervain’s tenosynovitis

  Patients present with symptoms at the radial aspect of the wrist near th
• Symptoms of De Quervain’s tenosynovitis

  • Pain, often radiating to the forearm
  • Aching
  • Burning
  • Weakness
  • Numbness
  • Tenderness
• Repetitive movement of the APL and EPB under the extensor retinaculum results in inflammation and swelling of the tendon sheaths
• There is a special test for De Quervain’s tenosynovitis called Finkelstein’s test
• Finkelstein’s test (or maybe Eichhoff’s test) involves the patient making a fist with their thumb inside their fingers. Then, the wrist is adducted (ulnar deviation), causing strain on the APL and EPB tendons. If this movement causes pain at the radial aspect of the wrist, the test is positive, indicating De Quervain’s tenosynovitis
• The original Finkelstein’s test involves the patient resting their forearm on a surface in a neutral position with the wrist hanging off and unsupported. The examiner holds the patient’s thumb and passively flexes the thumb into the palm, causing the wrist to adduct (ulnar deviation), putting strain on the APL and EPB tendons. If this causes pain at the radial aspect of the wrist, the test is positive, indicating De Quervain’s tenosynovitis
• Management of De Quervain’s tenosynovitis

  1. Rest and adapting activities

  2. Using splints to restrict movements

  3. Analgesia (e.g., NSAIDs)

  4. Physiotherapy

  5. Steroid injections

  6. Rarely, surgery may be required to release (cut) the extensor retinaculum, releasing the pressure and creating more space for the tendons
• Last updated

  August 2021