Article Figures & Data
Figures
- Figure 1a.
Anatomy of the first dorsal wrist extensor compartment: radial view.
- Figure 2.
Demonstration of Finkelstein’s test.
- Figure 3.
Injection of the first dorsal wrist extensor compartment.
Tables
- Table 1.
Selected Characteristics of Seven Studies that Examined the Treatment of de Quervain’s Tenosynovitis.
Study Characteristics Weiss et al1 1994 Harvey et al2 1990 Anderson et al3 1991 Witt et al4 1991 McKenzie5 1972 Zingas et al6 1998 Christie7 1955 Women’s wrists 80 70 50 64 25 12 16 Men’s wrists 13 12 5 19 5 7 4 Bilateral 0 0 1 4 0 0 0 Mean age, years (range) 38 (17–72) 45 (16–83) 47 (21–80) 44 (16–75) 49.5 (25–74) 39 (24–63) 46 (18–74) Demographics No difference in treatment success when comparing sex, hand dominance, age, or duration of symptoms Women with infants and small children, hand dominance, secretary, nursing occupation Housework, clerical No association found between sex, hand dominance, age, or duration Not noted Homemaker, barber, salesperson Tailor, cutter, seamstress, poster artist Criteria for diagnosis Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test Exclusion criteria Not noted Previous treatment No previous steroid injection within past 6 months Rheumatoid arthritis Not performed Previous wrist surgery, previous 1st extensor compartment injection, rheumatoid arthritis in pregnancy No obvious preceding trauma Duration of symptoms, mo (range) 7 (0.25–36) 3.2 (0.75–14) 4.4 (1–24) 5.35 (0.5–18) 1.25–9 3.9 (1–11) 8 (1–36) Injection medicine used 1 cc betamethasone, 1 cc 1% lidocaine Hydrocortisone acetate or methyl prednisolone acetate, “local” anesthetic Methyl-prednisolone, 80 mg, 1% Xylocaine 1.5 cc 40 mg methyl-prednisolone, 1% lidocaine 1 cc 25 mg hydrocortisone, 2% lidocaine 1 cc 6 mg Celestone, 1% lidocaine 3 cc 25 mg hydrocortisone acetate, 2% procaine 1 cc One injection 42 45 33 0 24 19 16 Repeated injection 0 7 14 0 5 0 4 Injection and splint 14 0 0 87 0 0 0 Thumb spica splint 37 0 39 0 0 0 0 NSAID 0 0 39 0 0 0 0 Rest 0 0 17 0 0 0 0 Definition of success Absence of diagnostic criteria Absence of diagnostic criteria Absence of diagnostic criteria Absence of diagnostic criteria Absence of diagnostic criteria Absence of diagnostic criteria Absence of diagnostic criteria Side effects Not noted 2 nontender nodules, 2 skin color changes Skin color changes and fat atrophy = 16, flare = 5 None None None Superficial thrombo-phlebitis (1) Failure 45 (underwent surgery) 11 (6 had 2 injections, 5 had 1 injection) 5 30 (within 3 months) 1 8 (3 had surgery, 5 had return of criteria) 1 Follow-up, mo (range) 4, 13 (6–14) 0.5, 20 (0.25–84) 1.5, 48 (6–71) 18 (12–30) 0.5, 1, 3, 18 1, 3 3.5 NSAID - nonsteroidal antiinflammatory drug.
Treatment Modality No. Percent Cured Injection 226 83 Injection and splint 101 61 Splint alone 76 14 Rest alone 17 0 Nonsteroidal antiinflammatory drugs 39 0
