Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
De Quervain's tenosynovitis is inflammation of tendons on the side of the wrist at the base of the thumb. These tendons include the extensor pollicis brevis and the abductor pollicis longus tendons.
De Quervain's tenosynovitis can be brought on by simple strain injury to the
extensor pollicus longus tendon. Typical causes include stresses such as lifting
young children into car seats, lifting heavy grocery bags by the loops, and
lifting gardening pots up and into place.
What are symptoms of De Quervain's tenosynovitis?
De Quervain's tenosynovitis causes pain and tenderness at the side of the wrist
beneath the base of the thumb. Sometimes there is slight swelling and redness in
the area.
How is De Quervain's tenosynovitis diagnosed?
De Quervain's tenosynovitis is diagnosed based on the typical appearance,
location of pain, and tenderness of the affected wrist. De Quervain's
tenosynovitis is usually associated with pain when the thumb is folded across
the palm and the fingers are flexed over the thumb as the hand is pulled away
from the involved wrist area. (This is referred to as the Finkelstein maneuver.)
How is De Quervain's tenosynovitis treated?
Treatments for De Quervain's tenosynovitis includes any combination of rest,
splinting, ice, antiinflammation medication, and/or cortisone injection.
Cortisone injection is extremely effective and is generally the optimal
treatment. Normal activity may be resumed within three weeks after an injection.
Surgery is only rarely necessary and usually reserved for persisting
inflammation after failure of at least one cortisone injection.
What is the
outlook (prognosis) with De Quervain's tenosynovitis?
Excellent. The patient can generally return to full function after the
inflammation quiets down with treatment. Sometimes bracing is used during future
activities that involve repetitive wrist motion.
Corticosteroids are a class of medications that are related to cortisone, a steroid. Medications of this class powerfully reduce inflammation. They are used to reduce the inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid."
Corticosteroids can be taken by mouth, inhaled, applied to
the skin, given intravenously (into a vein), or injected into the tissues of
the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), methylprednisolone sodium succinate injection
(Solu-Medrol) (given intravenously), as well as triamcinolone,
Kenalog, Celestone, methylprednisolone
(Depo-Medrol), and others (given by injection into body tissues). This
article describes the role of cortisone injections into the soft
tissues and joints.
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