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At least 19 recordsLinked to original sources
PubMed1997

Ultrasonographic evaluation of de Quervain disease.

De Quervain disease is a job-related tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis muscles; it is associated with pain and functional impairment and progresses to cause local fibrosis with blockage or triggering of the thumb. High-resolution ultrasonography of the wrist was performed in eight patients with de Quervain disease; the examination was performed in axial and coronal scans with a 13 MHz linear transducer. The evaluation of normal wrists helped to define the normal sonographic anatomy of the first extensor compartment; obvious changes of the tendon sheath were noted in all cases of de Quervain disease (thickening and edema of the synovial sheath and fluid within the sheath). We conclude that ultrasonography is able to confirm the clinical diagnosis of de Quervain disease and may have a role in the follow-up of this disorder.

Acute Disease↗
PubMed2005

Abductor pollicis longus tendon rupture in De Quervain's disease.

De Quervain's disease is a stenosing tenovaginitis involving the first extensor compartment of the wrist. The similarity of its symptomatology to a number of other conditions and its controversial aetiology are only a few of the barriers which often delay its diagnosis and treatment. We report the first two cases in the literature of abductor pollicus longus tendon rupture in patients with De Quervain's disease who had been treated with conservative methods. The relevant literature is reviewed.

Adult↗
PubMed2004

Treatment of de Quervain disease with triamcinolone injection with or without nimesulide. A randomized, double-blind, placebo-controlled trial.

BACKGROUND: There is uncertainty as to whether supplemental oral nonsteroidal anti-inflammatory medication improves the effectiveness of steroid injections in the treatment of de Quervain disease. We tested the hypothesis that there are no significant differences in the success rates when this condition is treated with triamcinolone injection with or without supplemental oral nimesulide. METHODS: In a randomized, double-blind trial, 160 patients with de Quervain disease received an injection of 10 mg of triamcinolone acetonide and either 200 mg of oral nimesulide for seven days (eighty patients) or placebo tablets for seven days (eighty patients). An independent, blinded evaluator assessed the primary outcomes (tenderness, pain, and the result on the Finkelstein test) at three weeks after injection. Adverse reactions were assessed, and probabilities of recurrence for both groups were compared. Factors possibly predictive of disease recurrence were also assessed. RESULTS: The success rate after one injection was 67% in the nimesulide group and 68% in the placebo group. The overall success rates after single or multiple injections with a mean follow-up of 13.6 months were 95% for both groups. No significant differences were noted with respect to the success rates (p = 0.69) or pain scores after treatment (p = 0.11). The most common adverse reactions to triamcinolone injection and nimesulide were pain after injection and dyspepsia, respectively. The symptoms of de Quervain disease recurred in 33% of the patients in the nimesulide group and in 37% of those in the placebo group. The median time of recurrence was at the fifth month in the nimesulide group and at the fourth month in the placebo group. The recurrence of symptoms was significantly (p = 0.01) related to the presence of crepitation (relative risk, 2.13; 95% confidence interval, 1.19 to 3.80). CONCLUSIONS: Supplemental oral administration of the nonsteroidal anti-inflammatory drug nimesulide does not improve the effectiveness of a single injection of triamcinolone acetonide in the treatment of de Quervain disease. Patients with crepitation in the first dorsal compartment during thumb extension or abduction are at increased risk for recurrence of this disease. LEVEL OF EVIDENCE: Therapeutic study, Level I-1b (randomized controlled trial [no significant difference but narrow confidence intervals]).

Administration, Oral↗
PubMed2005

Longitudinal incision in surgical release of De Quervain disease.

The objective of this paper is to contrast the use of a longitudinal incision in surgical decompression of De Quervain disease with a transverse incision. The advantages are ease in recognition of compartment variations and superficial branches of radial nerve and prevention of palmar tendon subluxation by permitting a more dorsal release of the compartment sheath. Since 2002, we have used a longitudinal skin incision instead of the classic transverse incision to release the first dorsal compartment.

Decompression, Surgical↗
PubMed2005

De Quervain disease in volleyball players.

BACKGROUND: Chronic inflammatory tendon diseases in athletes are frequent, and they often result from modifications in normal kinematics of a tendon associated with a patient's anatomical determinants. De Quervain stenosing tenosynovitis is an inflammatory disease of tendons of the first dorsal compartment of the wrist. There is no literature about this disease concerning professional volleyball players. HYPOTHESIS: Limited, multiple trauma on the dorsal radial portion of the wrist, associated with long training times, can be involved in the pathogenetic process of de Quervain disease in professional volleyball players. STUDY DESIGN: Case series; Level of evidence, 4. MATERIALS AND METHODS: The authors studied 45 consecutively enrolled volleyball players (27 professional, 18 nonprofessional) satisfying clinical criteria for the diagnosis of de Quervain stenosing tenosynovitis. All patients were evaluated by questionnaire and physical examination. They were divided into group A (mild) and group B (severe) based on the severity of the symptoms and physical findings; they were followed for a mean of 37 months. RESULTS: Total training quantity (mean weekly training time multiplied by mean sports activity duration) in group A was 74, whereas it was 155 in group B (P < .01). No neuropathies were found in group A, whereas they were found in 3 patients in group B. Fifty percent of surgical patients had a longitudinal fibrous septum, whereas 54% showed multiple tendon sheaths making up the abductor pollicis longus tendon. CONCLUSIONS: This study shows that increased training time and consequent microtrauma associated with professional volleyball activity can increase the likelihood of de Quervain disease.

Adolescent↗
PubMedDate not supplied

De Quervain's disease: diagnostic imaging.

De Quervain's disease constitutes the most frequently occurring stenotic tenosynovitis. The authors have studied which imaging technique allows for the best representation of anatomopathologic modifications. Ultrasound examination appeared to be the most appropriate and advantageous method as it reveals involvement of the sheaths and tendons in the simplest, most complete, and least expensive manner.

Female↗
PubMed1972

Conservative treatment of de Quervain's disease.

Thirty patients with de Quervain's disease were treated by injection of hydrocortisone acetate and lignocaine. A 93% incidence of complete relief of symptoms was obtained after 18 months. It is recommended that this is the treatment of choice before resorting to surgery.

Adult↗
PubMed2002

Comparison of nonsurgical treatment measures for de Quervain's disease of pregnancy and lactation.

de Quervain's disease of pregnancy and lactation is usually self-limited and responds well to nonsurgical treatment. We conducted a randomized prospective study on 19 wrists of 18 patients with de Quervain's disease who were either pregnant or breast-feeding. One group had a cortisone injection into the tendon sheath and the other group used thumb spica splints. All 9 patients with injections had complete pain relief with only one late recurrence. None of the patients with splints had complete pain relief; however, at the end of the lactation period, 8 had spontaneous resolution of symptoms and 1 received a cortisone injection. de Quervain's disease of pregnancy and lactation is self-limited and can be treated successfully with cortisone injection. Splinting does not provide satisfactory pain relief.

Adult↗
PubMed1996

MRI features in de Quervain's tenosynovitis of the wrist.

De Quervain's stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain's synovitis was suggested (n = 5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain's disease. De Quervain's tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings.

Adult↗
PubMed2000

Histological appearances in post-partum de Quervain's disease.

Six patients who developed de Quervain's disease during pregnancy or within 12 months of childbirth were treated surgically. Histopathological examination of the tendon sheaths using alcian blue stain showed that myxoid degeneration was responsible for the thickening observed in the sheath. Characteristic intramural deposits of mucopolysaccharides were present, predominantly in the subsynovial region. Acute or chronic inflammatory changes were not seen. These findings were the same as those described in patients with de Quervain's disease unrelated to pregnancy or childbirth.

Adult↗
PubMed2005

[The Omega "Omega" pulley plasty: a new technique for the surgical management of the De Quervain's disease].

The Omega "Omega" pulley plasty: a new technique for the surgical management of the De Quervain's disease. The De Quervain tenosynovitis is an inadequacy into the first extensor compartment between the osteo-fibrous tunnel and the tendons. This mechanical conflict generates a tenosynovitis of the extensor pollicis brevis and the abductor pollicis longus tendons. This is generally expressed by a tenderness on the radial side of the wrist over the radial styloid process. The medical management consists on corticoids infiltrations of the first extensor compartment, the avoidance of repetitive and stress movements of the first ray with the use of a rest splint. The surgical approach is considered with the recurrence of the painful symptoms. This well-known pathology is reputated to require a simple section of the pulley. Our post-operative complications have been reported in the literature of this classical surgical solution. These complications concern an incomplete release of the extensor pollicis brevis and the abductor pollicis longus tendons particularly when an extensor sub-compartment exists and was overlooked, an irritation of the collateral branches of the sensitive radial nerve or the occurrence of a nevroma after a nerve injury and the most serious complication is a palmar subluxation of the extensor tendons which can occur with the thumb extended and the wrist flexed. In rare cases, this subluxation can be really painful and requires a surgical management with secondary reconstruction of the pulley. This reconstruction necessitates distal pedicle flaps from the dorsal retinaculum or the brachioradialis tendon. To prevent these complications, Codega and Kapandji described techniques of reconstruction of the pulley after its release. More recently, Le Viet reported a procedure using the anterior flap of the pulley; fixed to the dermis it will work as a barrier and maintain the tendons sliding on the radial styloid groove. These techniques require to divide the pulley and to reconstruct it suturing the different flaps. It can generate adherences between the extensor tendons, the overlying skin and the collateral branches of the radial nerve. The authors present a new and original plasty procedure of the first extensor compartment pulley, the "Omega" Omega plasty. It consists to liberate the anterior attachment of the pulley over the anterior lip of the styloïd process respecting its continuity with the periosteum flap. This conservative procedure is very interesting; it permits enough expansion of the tunnel volume decompressing the extensor tendons as a treatment of the De Quervain disease and respecting the anatomy and the continuity of the osteo-fibrous tunnel. This technique is simple, reliable and respects the first ray extensor tendons gliding physiology and biodynamic. In spite of our short clinical experience with only ten cases, all the patients retrieve a normal function of the thumb with complete disappearance of the first ray tenderness and pain without any complications. These preliminary results are encouraging and push us to consider the "Omega" plasty as a first choice for the surgical treatment of the De Quervain tenosynovitis.

Humans↗