De Quervain's tenosynovitis

De Quervain's tenosynovitis is an inflammatory condition that affects the tendons located at the base of the thumb in the wrist. The affected tendons are those that connect the thumb muscles to the carpal bone (wrist). Inflammation of these tendons can cause pain, swelling, and difficulty moving the thumb and wrist.

Causes of De Quervain's tenosynovitis
De Quervain's tenosynovitis is caused by inflammation of two tendons in the wrist that move in a common tendon sheath. The inflammation occurs due to overuse or wear and tear of the tendons, which can be caused by repetitive activities such as writing, typing, gardening, sewing, playing video games, among others. It can also be caused by an injury or an autoimmune disease. Pregnancy can also contribute to the condition due to weight gain and changes in hormone levels.

Diagnosis of De Quervain's Tenosynovitis
The diagnosis of De Quervain's tenosynovitis is made through a combination of a physical examination, medical history, and imaging tests. The physical examination includes assessing swelling and pain at the base of the thumb, as well as limited movement in the wrist and thumb. The doctor may also perform a Finkelstein test, which involves bending the wrist inward and downward while holding the thumb, to determine if there is pain or weakness.

The medical history is also important in establishing the diagnosis, as activities and symptoms related to overuse of the hand must be considered.

In some cases, imaging tests such as X-rays, ultrasounds, or MRIs may be performed to rule out other conditions, such as a bone injury or arthritis.

De Quervain's Tenosynovitis Treatment
Treatment for De Quervain's tenosynovitis focuses on reducing inflammation and pain in the wrist and thumb, and improving hand function.

Initial treatment may include:

• Rest of the hand: avoiding activities that cause pain.
• Ice: applying ice to the affected wrist for 20 minutes every 2-3 hours to reduce inflammation.
• Pain relievers: such as paracetamol or ibuprofen to relieve pain.
• Physical therapy: specific exercises to strengthen and stretch the tendons and muscles of the wrist and thumb.

In severe cases or those that do not respond to conservative treatment, other options may be considered, such as:

• Ultrasound-guided steroid injections: to reduce inflammation and pain, and improve mobility.
• Surgery: In cases that do not respond to various conservative treatments, surgery may be performed to release the affected tendons. It is important to mention that treatment should be guided by a specialist, as it will depend on the severity of the condition and the patient's activity level.

It is also important to mention that preventative treatment is an important part of avoiding recurrence of the condition, especially avoiding activities that cause pain and strengthening and stretching the muscles and tendons of the wrist and thumb.