De-Quervain's Disease, also called tenosynovitis, is an inflammation of the extensor tendon sheath of the thumb.

De-Quervain's Disease is named after the surgeon who was the first to identify it. The thumb joint differs from the other fingers in its shape, its location and its own tendon system allowing it a wider movement range than that of the other fingers. The muscle mass at its base assists it in its opposed action to the other fingers. The muscles operating the thumb start at the middle finger and connect to two tendons, called the Abductor pollicis brevis and the Opponens pollicis, which in their action bend or straighten the thumb. The tendons are sheathed with strong connective tissue.

Causes for the development of inflammation in the tendon sheath

A thickening of the tendons and friction damage create the inflammation. The tendon thickening may be the result of direct trauma, strained activity or repeated activity.

Frequency of De-Quervain's Disease

De-Quervain's Disease typically appears in women in two age groups: around the age of 60 and among mothers of babies and thus it is called "the mothers' disease".

The disease may develop in people who use their thumbs in a repeated manner over time.

Characteristics of De-Quervain's Disease

Sensitivity at the thumb's side, sharp pain, swelling and warmth around the thumb, difficulty to reach the normal movement range, difficulties with grabbing objects.

Diagnosis of De-Quervain's Disease

It is possible to diagnose the disease by feeling around the thumb's base. The area is warm, inflated, sensitive and painful to touch.

Finkelstein Test - contracting the fingers into a fist, above the thumb, while tilting the wrist to the little finger's side causes sharp pain, which is typical for De-Quervain's Disease.

Treating De-Quervain's Disease

Using a splint - creating a situation of rest for the joint using a splint which support it and prevents its movement.

 

Anti-inflammatory medications - help reducing the inflammation in the joint, as well as the pain.

 

Cortisone injection - anti-inflammatory hormone used for focused treatment in reducing the inflammation and its accompanying pain.

 

Surgery - If the conservative treatment is inefficient there is need for surgical intervention in which a cut is performed in the bounding sheath of the tendons in order to release the pressure from them and thus preventing the friction which causes the inflammation

De- Quervain's Disease

Dr. Alon Covo

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