Orthopedics - de Quervain's Syndrome

de Quervain's Syndrome

Diagnosis/Definition

Tendonitis/Tenosynovitis of the extensor pollicis brevis and abductor pollicis longus within the extensor sheath of the first digit.

Initial Diagnosis and Management

• History and physical exam.
• Plain films, MRI, CT not required.
• Splinting: Wrist or thumb spica splint for one month (at minimum for aggravating activities).
• Activity Modification.
• Work simplification techniques.
• Modalities (i.e., heat, ice, ultrasound) as clinically indicated.
• Prescribe NSAID.

Ongoing Management and Objectives

Modification/continuation of initial management.

Indications for Specialty Care Referral

• Consider referral for injection in chronic cases.
• X-ray for chronic/traumatic cases.

Criteria for Return to Primary Care

Chronic condition that can be managed at primary care level with intermittent specialty care evaluation as needed.

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