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De Quervain’s Syndrome. Miss Meg Birks Consultant Hand Surgeon GP Education event 1 st March 2012. Presentation – symptoms. Radial Sided wrist pain Difficulty with everyday activities Writing/typing Opening bottles/jars Using scissors. Presentation - signs. - PowerPoint PPT Presentation
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De Quervain’s Syndrome
Miss Meg BirksConsultant Hand Surgeon
GP Education event 1st March 2012
Presentation – symptoms
• Radial Sided wrist pain
• Difficulty with everyday activities– Writing/typing– Opening bottles/jars– Using scissors
Presentation - signs
• Swelling and tenderness over the tendons
• Finklestein’s test positive
Differential Diagnosis
• OA base of thumb• STT joint OA• Scaphoid pathology• Carpal tunnel syndrome
Further Information
Injection technique• Position the wrist
on table, thumb side up
• Palpate the radial styloid
• Approach from distal (hand end) at 45°
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
Possible complications
• Irritation of superficial radial nerve• De pigmentation of skin• Fat atrophy• Failure to improve
– Consider confirming the diagnosis with USS
Any Questions?
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