A septum between the abductor pollicis longus tendon and the extensor pollicis brevis tendon in the first extensor compartment is frequently encountered during the surgical treatment of de Quervain's disease. But de Quervain's disease associated with a bone tumor and an osseous septum is very rare. We treated a patient with de Quervain's disease who had a bone tumor and an osseous septum between the abductor pollicis longus tendon and the extensor pollicis brevis tendon in the first extensor compartment. After the excision, the pain was relieved and Finkelstein's test was negtive. We report upon this case, and includea brief review of the literature.
De Quervain Disease* ; Humans ; Tendons

PURPOSE: The purpose of this study was to evaluate the effect of steroid injection according to the stage of Finkelstein's test and the severity of tenderness on radial styloid in de Quervain's disease. METHODS: Between January 2011 and December 2012, a total of 57 patients (57 wrists) treated with steroid injection in de Quervain's disease were enrolled on this study. The severity of tenderness, the stage of Finkelstein's test and pain score using visual analogue scale (VAS) were assessed before steroid injection. And the effect of steroid injection was assessed until one year after steroid injection. The relationship between the recurrence of de Quervain's disease after steroid injection and pre-injection findings including tenderness, Finkelstein's test and VAS was assessed. RESULTS: The success rate of steroid injection was 71.9% (41/57 patients). The outcome of steroid injection was not significantly related to the severity of tenderness (p=0.648), the stage of Finkelstein's test (p=0.530) and VAS score (p=0.607). CONCLUSION: The tenderness on radial styloid and the Finkelstein's test are important physical findings for the diagnosis of de Quervain's disease. However, the severity of tenderness and the stage of Finkelstein's test were not showed as predictive factors for the outcome.
De Quervain Disease* ; Diagnosis ; Humans ; Recurrence*

Stenosing tenosynovitis of styloid process of radius(de Quervain's disease) which abductor pollicis longus and extensor pollicis brevis in the first extensor chamber are affected by resistance when sliding, the incidence is affected by anatomical variations. Symptoms, signs and auxiliary examinations can diagnose the disease. Slight dQS can be improved by rest, brace, restriction activities, and oral medications. Chinese medicine and physiotherapy also reduce the disease. Needle knife therapy is a Traditional Chinese medicine minimally invasive surgery, which is also a step-by-step treatment between conservative treatment and open surgery to loosening the compression of the first extensor chamber. Steroid injection is a more common treatment in this disease, and its efficacy is related to the accuracy of the injection and is affected by the severity of the patient's anatomical variation. Identifying the spacing within the first extensor chamber under ultrasound can help patients better choose conservative or surgical treatment. Surgical treatment can more completely change the condition of dQD from anatomical structure, and clinical should pay attention to the choice of surgical procedure to improve the efficacy and reduce the occurrence of surgical complications. This article discusses the pathogenesis, diagnosis and treatment of the disease from the perspective of anatomical structure. It mainly analyzes the therapeutic targets and the clinical application, which aims to provide reference for the diagnosis and treatment of de Quervain disease.
De Quervain Disease ; Humans ; Radius ; Tendon Entrapment ; Tenosynovitis ; Wrist Joint

De Quervain's disease is the most common form of tenosynovitis, which causes disability in daily living and occupational activity. Anatomical variations in the first extensor compartment including separate comparment influenced the effects of treatment. A 45-year-old woman had severe pain on wrist and suffered in activity of daily living after motor vehicle accident. She had swelling and tenderness upon the radial styloid process, and more aggravated pain by Finkelstein's maneuver test. The magnetic resonance imaging (MRI) scans showed severe peritendinous edema within the synovial sheath, increased signal intensity within the tendons. Also, the images revealed a thickened septum between abductor pollicis longus and extensor pollicis brevis. Corticosteroid was injected on both sides of the septum. We report a case of definite septum of de Quervain's disease via MRI scans.
De Quervain Disease* ; Edema ; Female ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Motor Vehicles ; Tendons ; Tenosynovitis ; Wrist

We treated the 90 wrists (83 patients) with de Quervain's disease, and studied retrospectively the factors affecting the result of treatment, and the results of several treatment modalities, compared with published series of this disease. There was significant association between outcome and duration of symptoms before treatment, but age, sex, associated disease, and hand dominance were not associated(chi-square test, p < 0.05). And 75 wrists received single injections of steroid and local anesthetic into the tendon sheaths with complete pain relief in 59 wrists (69%). Furthermore, an additional injection gave pain abatement in 6 wrists. And regardless of treatment method, 95% of the whole patients had satisfactory outcome at a mean of 54 months (minimum follow-up, 45 months). We concluded that injection of steroid is the preferred initial treatment in de Quervain's disease, giving complete and lasting relief in 87% of cases.
De Quervain Disease ; Follow-Up Studies ; Hand ; Humans ; Methods ; Retrospective Studies ; Tendons ; Wrist

BACKGROUND: Few studies have evaluated surgical outcomes in patients with refractory de Quervain's disease using validated outcome measures. We assessed the clinical outcomes of dorsal release of the first extensor compartment for the treatment of de Quervain's disease using the disabilities of the arm, shoulder and hand (DASH) score. METHODS: From October 2003 to May 2009, we retrospectively evaluated 33 patients (3 men and 30 women) who underwent surgical treatment for de Quervain's disease. All patients had a positive Finkelstein test and localized tenderness over the first dorsal compartment. All operations were performed under local anesthesia. A 2-cm-long transverse skin incision was made over the first extensor compartment and the dorsal retinaculum covering the extensor pollicis brevis was incised longitudinally. Preoperative and postoperative clinical evaluation included the use of DASH score, Finkelstein test, and visual analogue scale (VAS) score. RESULTS: In 18 patients (55%), the extensor pollicis brevis tendon compartment was separated from the abductor pollicis longus compartment. Eight patients had intracompartmental ganglia in the extensor pollicis brevis subcompartment. All patients except one had negative sign on Finkelstein test at the last follow-up. The average VAS score decreased from 7.42 preoperatively to 1.33 postoperatively (p < 0.05), and DASH score was improved from 53.2 to 3.45 (p < 0.05). There were no postoperative complications such as subluxation of the tendon of the first dorsal compartment or injury to the sensory branch of the radial nerve. CONCLUSIONS: Intracompartment ganglia and the separate septum of extensor pollicis brevis are often related to de Quervain's disease. The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity.
Adult ; Aged ; Chronic Disease ; De Quervain Disease/diagnosis/*surgery ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Recurrence ; Retrospective Studies

Indicators for local steroid injection on the hands include trigger finger, De Quervain's disease, carpal tunnel syndrome and trapeziometacarpal joint arthritis. Local steroid injection is an effective technique for rapid alleviation of symptoms and return to daily life. Complications following local steroid injection include depigmentation of the skin, subcutaneous fat atrophy, infection and tendon rupture. Tendon rupture and infection rarely occur as severe complications, and local steroid injection should not be abused or misused. The authors experienced a rupture of the extensor mechanism at extensor zone V after repeated local steroid injection to treat vague pain in the second metacarpophalangeal joint, followed by reconstruction of the extensor mechanism through tendon transfer and sagittal band reconstruction. We herein report a case with the literature review.
Arthritis ; Atrophy ; Carpal Tunnel Syndrome ; De Quervain Disease ; Fingers ; Hand ; Joints ; Metacarpophalangeal Joint ; Rupture* ; Skin ; Steroids ; Subcutaneous Fat ; Tendon Transfer ; Tendons

Objectives: The prevalence of cumulative trauma disorders of upper extremities mons watch assembly workers in small-scaled industry was studied. Methods: In 83 workers at five watch assembly factories, symptoms and psychosocial questionnaire, ergonomic Interview, physical examination were conducted. Results: Prevalence of self-reported symptoms was 54.2% and neck 34.9%, wrist/hand 31.3%, shoulder 30.1%, elbow/arm 18.0% by anatomical site. Prevalence of cumulative trauma disorders was 45.8%. Most common disease was myofascial pain syndrome (31.3%). The other diseases were De Quervain disease (9.6%), tenosynovitis/tendinitis at wrist/hand (9.6%), bicipital tendinitis(6.0%), fat. epicondylitis(4.8%), meIn. epicondylitis(2.4%), and cervical disc disease(2.4%). As result of ergonomic interview, repetitiveness was 79(98.8%). There were no differences in the prevalence of self-reported symptoms and cumulative trauma disorders for age, sex, marital status, duration of work In the study, The significant factors of cumulative trauma disorders were occupational task and psychosocial stress in the study. The prevalence of cumulative trauma disorders in high strain group was hlgher (68.4%) than other three groups. The prevalence of self-reported symptoms and cumulative trauma disorders in assembly task was higher (70.0%, 64.0%) than other two tasks. Conclusions: Prevalence of self-reported symptoms was 54.2%, prevalence of cumulative trauma disorders was 45.8% in watch assembly workers. In this study, factor related to self-reported symptoms was occupational task and factors relaxed to cumulative trauma disorders were occupational task and psychosocial stress. This results suggest that differences of ergonomics and environment in occupational task cause differences of prevalence of self-reported symptoms and cumulatlve trauma disorders.
Cumulative Trauma Disorders* ; De Quervain Disease ; Human Engineering ; Marital Status ; Myofascial Pain Syndromes ; Neck ; Physical Examination ; Prevalence* ; Questionnaires ; Shoulder ; Upper Extremity*

The purpose of this study is to investigate the current status of and to collect the basic informations of musculoskeletal diseases of upper extremities in manufacturing and telecommunication companies. The subjects were 213 workers, consisted Of 98 manufacturing workers and 115 telephoBfi operators. The musculoskeletal ,symptom survey, Job safety analysis (JSA), and medical examinations including neurologic, and'nerve.cqnduction velocity (NCV) test were conducted.: All workers were women in company A, while the other composed of 68(69.4%) men and 30(30.6%) women. The results were as follows: 1. The rates of self-reporting symptoms in each company were 85.2% at the neck, 81.1% at the shoulder joint, 73.0% at the wrist joint and 34.8% at the elbow joint in company A, while 56.1% at the shoulder joint, 51.2% at the neck and 23.5% at the elbow joint in company B in order. 2. No relationship was observed between the work duration and symptom rate in company A, but the highest symptom rate was observed at the neck in 10-19 year work duration group, at the shoulder, elbow and wrist joint in 5-9 year work duration group in company B. 3. Over the 22.8% of total workers in this study having symptoms got medical treatment at the medical clinics or drug stores, but there was no statistical difference between both companies. 4. In company A, 16(13.9%) workers were classified as D category, 12(10.4%) workers as C category and 2(1.7%) workers as R category among 115 workers. And D category was 10(10.2%), C category 31(31.6%) and R category 4(4.0%) among 98 workers in company B. D category means disease category needed futher treatment, C category means disease category needed no treatment and R category means recheck category, needed futher evaluation. 5. The types of musculoskeletal disorders including D, C, and R category were 46 cases(D 13, C 30, R 3) of tension neck .syndrome (TNS), 16 cases (D 3, C 8, R 5) of carpal tunnel syndrome (CTS), 5 cases of De Quervain's disease, 3 cases of lateral epicondylitis, 3 cases of bicipital tendinitis, 3 cases of rotator cuff tendinitis, 2 cases of medical epicondylitis, and 5 cases of cervical disc syndrome. 6. In company A, the total cases of 11 TNS, 8 CTS, 3 De Quervain's disease, 3 lateral epicondylitis, 3 rotator cuff tendinitis and 1 cervical disc syndrome were diagnosed and so were total cases of 35 TNS, 8 CTS and 4 cervical disc syndrome in company B. 7. By stepwise multiple regression analysis with dichotomization of musculoskeletal disease, the following odds ratios were significantly high (p<0.05)-sex (2.707) and age(l.926).
Carpal Tunnel Syndrome ; Cumulative Trauma Disorders ; De Quervain Disease ; Elbow ; Elbow Joint ; Female ; Humans ; Male ; Musculoskeletal Diseases* ; Neck ; Odds Ratio ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Telecommunications* ; Tendinopathy ; Upper Extremity* ; Wrist Joint

The purpose of this study is to investigate the current status of and to collect the basic informations of musculoskeletal diseases of upper extremities in manufacturing and telecommunication companies. The subjects were 213 workers, consisted Of 98 manufacturing workers and 115 telephoBfi operators. The musculoskeletal ,symptom survey, Job safety analysis (JSA), and medical examinations including neurologic, and'nerve.cqnduction velocity (NCV) test were conducted.: All workers were women in company A, while the other composed of 68(69.4%) men and 30(30.6%) women. The results were as follows: 1. The rates of self-reporting symptoms in each company were 85.2% at the neck, 81.1% at the shoulder joint, 73.0% at the wrist joint and 34.8% at the elbow joint in company A, while 56.1% at the shoulder joint, 51.2% at the neck and 23.5% at the elbow joint in company B in order. 2. No relationship was observed between the work duration and symptom rate in company A, but the highest symptom rate was observed at the neck in 10-19 year work duration group, at the shoulder, elbow and wrist joint in 5-9 year work duration group in company B. 3. Over the 22.8% of total workers in this study having symptoms got medical treatment at the medical clinics or drug stores, but there was no statistical difference between both companies. 4. In company A, 16(13.9%) workers were classified as D category, 12(10.4%) workers as C category and 2(1.7%) workers as R category among 115 workers. And D category was 10(10.2%), C category 31(31.6%) and R category 4(4.0%) among 98 workers in company B. D category means disease category needed futher treatment, C category means disease category needed no treatment and R category means recheck category, needed futher evaluation. 5. The types of musculoskeletal disorders including D, C, and R category were 46 cases(D 13, C 30, R 3) of tension neck .syndrome (TNS), 16 cases (D 3, C 8, R 5) of carpal tunnel syndrome (CTS), 5 cases of De Quervain's disease, 3 cases of lateral epicondylitis, 3 cases of bicipital tendinitis, 3 cases of rotator cuff tendinitis, 2 cases of medical epicondylitis, and 5 cases of cervical disc syndrome. 6. In company A, the total cases of 11 TNS, 8 CTS, 3 De Quervain's disease, 3 lateral epicondylitis, 3 rotator cuff tendinitis and 1 cervical disc syndrome were diagnosed and so were total cases of 35 TNS, 8 CTS and 4 cervical disc syndrome in company B. 7. By stepwise multiple regression analysis with dichotomization of musculoskeletal disease, the following odds ratios were significantly high (p<0.05)-sex (2.707) and age(l.926).
Carpal Tunnel Syndrome ; Cumulative Trauma Disorders ; De Quervain Disease ; Elbow ; Elbow Joint ; Female ; Humans ; Male ; Musculoskeletal Diseases* ; Neck ; Odds Ratio ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Telecommunications* ; Tendinopathy ; Upper Extremity* ; Wrist Joint