De Quervain’s tenosynovitis

38 yr/F presented with painful swelling along the radial aspect of the wrist since several weeks. The pain was aggravated by activities such as grasping & lifting objects.

Ultrasound (US) imaging shows diffuse thickening of the extensor retinaculum over abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. Mild effusion with synovial hypertrophy is seen in the APL & EPB tendon sheath. Power Doppler shows increased vascularity in the thickened synovium. Dynamic imaging shows restricted gliding of APL & EPB tendons below the thickened extensor retinaculum. Based on the clinical presentation & imaging findings, a diagnosis De Quervain’s tenosynovitis was made.

De Quervain’s tenosynovitis is a common condition that affects the wrist & hand. It is characterized by pain & swelling in the region of the radial styloid. De Quervain’s tenosynovitis is caused due to a mechanical etiology.

US imaging is a useful tool in the diagnosis and management of this condition. It can help to identify the affected tendons and assess the extent of inflammation. US guided intra-sheath steroid injection is an extremely rewarding procedure in this condition.