de Quervain's Syndrome

Diagnosis/Definition

Tendonitis/Tenosynovitis of the extensor policies brevis and abductor policies longus within the extensor sheath of the first digit.
Initial Diagnosis and Management

• History and physical exam.
• Plain films, MRI, CT not required.
• Splinting: Wrist or thumb spica splint for one month (at minimum for aggravating activities).
• Activity Modification.
• Work simplification techniques.
• Modalities (i.e., heat, ice, ultrasound) as clinically indicated.
• Prescribe NSAID.

Ongoing Management and Objectives

Modification/continuation of initial management.

Indications for Specialty Care Referral

• Consider referral for injection in chronic cases.
• X-ray for chronic/traumatic cases.

Criteria for Return to Primary Care