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Answer: De Quervain's Tenosynovitis.

Findings

  • Plain film of right wrist is unremarkable

  • MRI of right wrist demonstrates tendonopathy and tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons in the first compartment of the wrist underneath the fiducial marker indicating where patient feels pain.
De Quervain's Tenosynovitis

  • De Quervain's tenosynovitis is inflammation of tendons on the side of the wrist at the base of the thumb. These tendons include the extensor pollicis brevis and the abductor pollicis longus tendons.

  • De Quervain's tenosynovitis can be brought on by simple strain injury to the extensor pollicus longus tendon. Typical causes include stresses such as lifting young children into car seats, lifting heavy grocery bags by the loops, and lifting gardening pots up and into place.

  • Clinical: De Quervain's tenosynovitis causes pain and tenderness at the side of the wrist beneath the base of the thumb. Sometimes there is slight swelling and redness in the area.

  • Treatment: Treatments for De Quervain's tenosynovitis includes any combination of rest, splinting, ice, antiinflammation medication, and/or steroid injection. Cortisone injection is extremely effective and is generally the optimal treatment. Normal activity may be resumed within three weeks after an injection. Surgery is only rarely necessary and usually reserved for persisting inflammation after failure of at least one cortisone injection.

References
  • Brant, William E. and Helms, Clyde A. Fundamentals of Diagnostic Radiology. 3rd ed, Lippincott Williams and Wilkins, Philadelphia, 2006. Volume 4. p. 1149.

  • Manaster, B.J., et. al. Musculoskeletal Imaging: The Requisites. 3rd ed, Mosby, Philadelphia, 2007. Pp. 503-506.

  • www.statdx.com

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