L

Figure 30—1. Physical exam will localize pain and swelling over the region of the radial styloid.

Radial Styloid Tenosynovitis

Diagnosis

De Quervains Tenosynovitis of the Right Wrist

De Quervains disease may be caused by any condition that produces a swelling or a thickening of the tendons of the first dorsal compartment of the wrist (Fig. 30—3A). It is a stenosing tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons (Fig. 30-3B). This typically occurs in the third, fourth, and fifth decades of life and is 10 times more common in women. The cause is usually related to overuse and may be associated with rheumatoid arthritis. Overuse causes a chronic inflammation of the sheath that covers the long abductor and the short extensor tendons.

The tendons of the APL and the EPB pass through a fibro-osseous tunnel formed by a groove in the radial styloid and overlying extensor retinaculum

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