Best Practice Case Studies-Case 158 Asset 6 Ultrasound: De Quervain's Tenosynovitis

Video Transcription

Video Summary

Dr. Eugene Rowe presented a detailed ultrasound case of a 36-year-old woman with postpartum right radial wrist pain, positive Finkelstein test, and suspected De Quervain tenosynovitis. He reviewed wrist scanning technique, emphasizing transducer choice, wrist positioning, stabilization, and how to identify key dorsal wrist landmarks, especially Lister’s tubercle and the first extensor compartment. He highlighted the frequent anatomic variation of a septum between the APL and EPB tendons, which can create subcompartments and affect both diagnosis and treatment. <br /><br />The presentation also covered differential diagnoses, including intersection syndrome, superficial radial neuropathy, and less common vascular causes. In the case images, ultrasound showed tenosynovial thickening and hypoechoic fluid around the EPB, with a septum present and relative sparing of the APL, supporting De Quervain disease involving a subcompartment. <br /><br />He discussed how recognizing septation matters for steroid injections and surgical planning, since missed subcompartments can contribute to treatment failure. The talk concluded with practical tips for reporting, including documenting technique, comparing sides, using clear orientation labels, and correlating findings with clinical symptoms.

Meta Tag

Concept de Quervain Tenosynovitis

Concept First Dorsal Compartment

Concept Ultrasound

Concept Abductor Pollicis Longus Tendon

Concept Extensor Pollicis Brevis Tendon

Edition 4th Edition

Related Case 4th Edition, Case 158

Topic Wrist

Keywords

4th Edition

4th Edition, Case 158

Wrist

De Quervain tenosynovitis

ultrasound wrist

first extensor compartment

septum

APL EPB tendons

Lister's tubercle

steroid injection planning

First Dorsal Compartment

Ultrasound

Abductor Pollicis Longus Tendon

Extensor Pollicis Brevis Tendon