De Quervain's tenosynovitis

Case contributed by Dr Yasser Asiri

Presentation

Wrist pain and swelling.

Patient Data

Age: 50 years
Gender: Female
MRI

There is circumferential fluid with few septations seen in the tendon sheath of the first extensor compartment with surrounding soft tissue edema. In addition, there is tendinosis of the first compartment tendons manifested by thickening and intermediate signal intensity. These findings are in keeping with de Quervain tenosynovitis. The rest of extensor tendons and flexor tendons appear within normal limits. 

There is intermediate T2 signal intensity involving triangular fibrocartilage with probable partial tear involving foveal insertion and meniscus homolog. There are edema and subchondral cystic changes involving ulnar aspect of lunate.

Case Discussion

Tenosynovitis of the first extensor compartment is characteristic of De Quervain tenosynovitis and it is usually seen at the level of radial styloid. The finding is probably attributed to repetitive gliding of the tendons against the underlying bone.  Some people may have complete septum between the two tendons and may require two separate steroid injections to treat the inflammation. Note that the appearance of several fascicles within the abductor pollicis tendon is considered a normal variant which can be mistaken for tendon tear.

PlayAdd to Share

Case information

rID: 65508
Published: 4th Mar 2019
Last edited: 4th Mar 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.