Dequivarians Tenosynovitis

Overview:

Typical name, of a common condition occurring in young nursing mothers. Typical symptom is pain in the upper portion of the wrist connecting with the thumb. This is also demarcated as base of thumb. Dequivarians tenosynovitis refers to the swelling in the tendon and it’s covering due to overuse of the tendon. There are namely two tendons which make the movement at the thumb. Each tendon is encased with a sheath of tissue which is called tenosynovium. Pain is typically felt at the base of thumb which runs across the wrist to the forearm also in long standing cases.

The tendons of the thumb due to overuse, get swollen and lead to pain - Dequivarians tenosynovitis
The tendons of the thumb due to overuse, get swollen and lead to pain – Dequivarians tenosynovitis

Causes:

This is commonly associated with repetitive activities making use of the same tendon. This is also seen in water retaining states like pregnancy, rheumatoid arthritis, hypothyroidism and other metabolic and endocrine disorders. Most patients do extremely well with conservative treatment using medications and physiotherapy. While a few may even require a surgical release of the tenosynovial tissue. Metabolic screening remains imperative in these patients to rule out the basic cause.

Treatment:

Dequivarians tenosynovitis is basically an overuse pathology and rest to the affected part remains imperative. Most cases which present early do extremely well with thumb spica splint and ice packs along with anti-inflammatory medications. Physiotherapy plays an important role in reducing symptoms. In chronic cases, a local steroid is injected around the tendon sheath and a cast/plaster may be applied to give rest. In recalcitrant  cases & where immobilisation isn’t possible, a surgical release may be the preferred modality of treatment. The release may be performed under local anaesthesia and is a day care procedure. There are usually minimal side effects of the procedure.

The tendons of the thumb due to overuse, get swollen and lead to pain - Dequivarians tenosynovitis
Best way is to detect early and treat conservatively. https://www.medicalnewstoday.com/articles/320914
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