De Quervain tenosynovitis

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Non-traumatic onset of Pain on radial aspect of LEFT wrist - 1 mth. Referred for Wrist US with clinical diagnosis of De Q.

Patient Data

Age: 55 yrs
Gender: Female
ultrasound

Thickening of common synovial sheath of 1st extensor compartment is noted. There is a thickened vertical septum between two tendons of 1st extensor compartement.

The abductor pollicis longus and extensor pollicis brevis tendons show thickening along with few tiny hypoechoic cleft. No tendon tear is detected. Significant hypervascularity is noted locally.

No tendon thickening or peritendinous fluid. Hypervascularity is noted at intersection of 1st and 2nd extensor compartment.

There is no tenosynovitis / tendinosis involving the rest of the extensor compartment. There is no dorsal ganglion. No effusion is noted at radiocarpal / intercarpal joints. No thrombosis of radial artery is noted at wrist.

Case Discussion

Surgery : Findings confirmed. A vertical septum was present.

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