September 12, 2024

Ultrasound of de Quervain’s Tenosynovitis

8 minutes

In this radiology lecture, we review the ultrasound appearance of de Quervain’s Tenosynovitis!

Key teaching points include:

Stenosing tenosynovitis of first extensor compartment tendons = Extensor pollicis brevis (EPB) and abductor pollicis longus (APL)

Second most common hand entrapment tendinopathy after trigger finger

Most common in middle-aged females

Associations include repetitive hand motions, pregnancy, arthritis, and trauma

Clinical presentation: Pain with thumb and wrist movement, tenderness and swelling at radial styloid

Positive Finkelstein maneuver may be present: Grasp thumb, ulnar deviate hand = Pain over distal radius

Ultrasound findings: Increased fluid in EPB/APL tendon sheath (tenosynovitis), hypoechoic, edematous tendon thickening (tendinosis), and thickening of extensor retinaculum (comparison scanning of contralateral thumb helpful)

Advanced findings: Impaired tendon movement, tendon tear (anechoic clefts), retinacular and peritendinous hyperemia

Don’t confuse normal APL slips with longitudinal tear (“lotus root” sign)

Important to identify variant intertendinous septa: Helps to properly guide steroid injection, increased incidence of asymmetric EPB involvement

If conservative therapy fails, surgical decompression may be required. More likely when septum present

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

Spotify: https://spoti.fi/462r0F2

Instagram: https://www.instagram.com/Radquarters/

Facebook: https://www.facebook.com/Radquarters/

X (Twitter): https://twitter.com/Radquarters

Reddit: https://www.reddit.com/user/radiologistHQ/

The post Ultrasound of de Quervain’s Tenosynovitis appeared first on Radquarters.

...more

View all episodes

By Daniel J. Kowal, MD

4.9

7676 ratings