AMSSM Sports Medcasts Top Sports Medicine Articles Podcast – Management of de Quervain Tenosynovitis
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Dec 20, 2024 Dr. Emily Eshleman, a sports and exercise medicine physician at UMass Chan School of Medicine, unpacks the management strategies for de Quervain Tenosynovitis. She compares treatment methods like corticosteroid injections and immobilization, emphasizing the power of ultrasound-guided approaches. Eshleman discusses the importance of patient-reported outcomes and how different strategies impact pain and function. With a push for better clinical practices, she also highlights gaps in existing research and the potential of innovative treatments like shockwave therapy.
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De Quervain's Prevalence vs. Management Guidelines
- De Quervain's tenosynovitis is a common musculoskeletal condition frequently encountered in medical training.
- Despite its familiarity, there's a surprising lack of established best practices for its treatment.
De Quervain's: Overuse, Not Inflammation
- De Quervain's tenosynovitis is now understood as a stenosing or overuse injury, rather than purely inflammatory.
- This overuse injury affects the first extensor dorsal compartment of the wrist, impacting the EPB and APL tendons.
Treatment Algorithm for De Quervain's
- Upon diagnosing De Quervain's, administer a corticosteroid injection and apply a thumb spica splint for 3-4 weeks.
- If symptoms persist, use ultrasound to confirm the diagnosis and consider a second ultrasound-guided injection.