Answer for CoW 19 March 2017
De Quervain’s Tenosynovitis.
Findings
Hyperintensity compatible with tenosynovitis within the first dorsal extensor compartment, with enlargement of the APL tendon. Intermediate signal intensity thickening surrounds the APL and EPB tendons on the T1.
Discussion
Tenosynovitis and tendinosis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons is called de Quervain’s tenosynovitis. First described by Swiss surgeon Fritz de Quervain in 1895, this condition is commonly encountered as an overuse injury. Swelling associated with tenosynovitis and tendinosis in the first dorsal compartment leads to painful restriction of movement of the thumb. The extensor retinaculum, through septa and direct attachments, forms the roof of the six extensor compartments. These fibro-osseous tunnels contain the extensor tendons of the wrist and hand. The first dorsal compartment overlies the radial styloid and contains the APL and EPB tendons, which are responsible for abduction and extension of the thumb. In de Quervain’s tenosynovitis, thickening and edema result in restriction of the normal gliding of the tendons through the relatively non-pliable first extensor fibro-osseous compartment.
Findings
Hyperintensity compatible with tenosynovitis within the first dorsal extensor compartment, with enlargement of the APL tendon. Intermediate signal intensity thickening surrounds the APL and EPB tendons on the T1.
Discussion
Tenosynovitis and tendinosis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons is called de Quervain’s tenosynovitis. First described by Swiss surgeon Fritz de Quervain in 1895, this condition is commonly encountered as an overuse injury. Swelling associated with tenosynovitis and tendinosis in the first dorsal compartment leads to painful restriction of movement of the thumb. The extensor retinaculum, through septa and direct attachments, forms the roof of the six extensor compartments. These fibro-osseous tunnels contain the extensor tendons of the wrist and hand. The first dorsal compartment overlies the radial styloid and contains the APL and EPB tendons, which are responsible for abduction and extension of the thumb. In de Quervain’s tenosynovitis, thickening and edema result in restriction of the normal gliding of the tendons through the relatively non-pliable first extensor fibro-osseous compartment.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!