UMEM Educational Pearls

Category: Orthopedics

Title: DeQuervain's and Intersection Syndrome

Keywords: DeQuervain, Intersection, Tenosynovitis (PubMed Search)

Posted: 3/30/2008 by Michael Bond, MD (Updated: 2/18/2020)
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DeQuervain and Intersection Syndromes:
 

  • DeQuervain's Syndrome (Tenosynovitis of the Abductor Pollicus Longus and Extensor Pollicus Brevis tendons) is a common disorder that has received a lot of press lately as BlackBerry Thumb or Gamer's Thumb.
    • This condition can be diagnosised by the Finklestein test [Have the patient bend their thumb into the palm of their hand, and then make a fist.  They should then ulnar deviate their wrist.  Pain along the tendons secures the diagnosis.]
    • The pain of DeQuervain's syndrome is typically along the distal end of the radius at the base of the thumb.
  • Intersection syndrome is a less common disorder though closely related to DeQuervain's Syndrome
    • The pain is usually felt on the top of the forearm about three inches proximal to the wrist. 
    • The pain from this condition is due to tenosynovitis of the Extensor carpi radialis longus and Extensor Carpi radialis brevis muscles/tendons caused by the intersection of them with the Extensor pollicus brevis and Abductor pollicus longus tendons.
    • Occurs due to excessive wrist movements.
    • Intersection syndrome can be seen in weight lifters, skiers, and can be seen in homeowners in the fall and winter when they rake a lot of leaves or shovel snow.
  • Treatment is the similar for both conditions and consists of:
    • NSAIDS
    • Cortisone injections can be effective
    • Thumb and wrist immobilization with a Thumb Spica Splint or Cock Up Wrist Splint