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De Quervain’s Syndrome: Diagnosis and Treatment Presentation

Learn about De Quervain’s Syndrome, differential diagnosis, injection technique, and possible complications from Hand Surgeon Miss Meg Birks at GP Education event on 1st March 2012.

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De Quervain’s Syndrome: Diagnosis and Treatment Presentation

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  1. De Quervain’s Syndrome Miss Meg Birks Consultant Hand Surgeon GP Education event 1st March 2012

  2. Presentation – symptoms • Radial Sided wrist pain • Difficulty with everyday activities • Writing/typing • Opening bottles/jars • Using scissors

  3. Presentation - signs • Swelling and tenderness over the tendons • Finklestein’s test positive

  4. Differential Diagnosis • OA base of thumb • STT joint OA • Scaphoid pathology • Carpal tunnel syndrome

  5. Further Information

  6. Injection technique • Position the wrist on table, thumb side up • Palpate the radial styloid • Approach from distal (hand end) at 45°

  7. Injection technique • Insert needle to bone and then withdraw a few millimetres • Inject – hope to see a “sausage” of fluid form • Reposition needle (same entry point) if strong resistance

  8. Possible complications • Irritation of superficial radial nerve • De pigmentation of skin • Fat atrophy • Failure to improve • Consider confirming the diagnosis with USS

  9. Any Questions?

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