Generic placeholder image

Current Rheumatology Reviews

Editor-in-Chief

ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Case Report

de Quervain’s Tenosynovitis with Accessory Abductor Pollicis Longus Tendon and ‘Wartenberg’s syndrome’ - A Case Report

Author(s): Md Abu Bakar Siddiq*

Volume 19, Issue 2, 2023

Published on: 21 October, 2022

Page: [230 - 234] Pages: 5

DOI: 10.2174/1573397118666220920095156

Price: $65

Abstract

Background: de Quervain's tenosynovitis (dQT) is focal soft-tissue rheumatism of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. The Swiss surgeon Fritz de Quervain first demonstrated the disorder in 1895. Anatomical variation of the first wrist extensor compartment, for example, accessory APL, can be associated with de Quervain's tenosynovitis. Sometimes, dQT may coexist with superficial radial nerve (SRN) compression, widely known as 'Wartenberg’s syndrome'.

Case Presentation: In the present case study, clinical features of de Quervain's tenosynovitis have been described in a 45-year-old housewife without any known risk factor for the disorder. The patient complained of pain and swelling on the radial aspect of dorsal wrist; there was local tenderness, and the Finkelstein test was positive. An ultrasonogram of the wrist's first extensor compartment depicted a thick, hypoechoic tenosynovial sheath encircling two APL and one EPB tendon. Swollen first extensor wrist compartment compressing the SRN led to tingling and dysesthesia, 'Wartenberg’s syndrome.'

Conclusion: de Quervain's tenosynovitis with accessory abductor pollicis longus tendon may present with ‘Wartenberg’s syndrome’.

Keywords: deQuervains tenosynovitis, accessory abductor pollicis tendon, Wartenberg syndrome, ultrasonography, case report

[1]
Satteson E, Tannan SC. De Quervain Tenosynovitis StatPearls. Treasure Island, FL: StatPearls Publishing 2022.
[2]
Stahl S, Vida D, Meisner C, Stahl AS, Schaller HE, Held M. Work related etiology of de Quervain’s tenosynovitis: A case-control study with prospectively collected data. BMC Musculoskelet Disord 2015; 16(1): 126.
[http://dx.doi.org/10.1186/s12891-015-0579-1] [PMID: 26018034]
[3]
Bahm J, Szabo Z, Foucher G. The anatomy of de Quervain’s disease. Int Orthop 1995; 19(4): 209-11.
[http://dx.doi.org/10.1007/BF00185223] [PMID: 8557414]
[4]
Clarke MT, Lyall HA, Grant JW, Matthewson MH. The histopathology of de Quervain’s disease. J Hand Surg [Br] 1998; 23(6): 732-4.
[http://dx.doi.org/10.1016/S0266-7681(98)80085-5] [PMID: 9888670]
[5]
Kuschner SH, Berihun H. Robert Wartenberg’s syndrome and sign: A review article. Open Orthop J 2021; 15: 13-6.
[6]
Beutel BG, Doscher ME, Melone CP Jr. Prevalence of a septated first dorsal compartment among patients with and without de quervain tenosynovitis: An in vivo anatomical study. Hand 2020; 15(3): 348-52.
[http://dx.doi.org/10.1177/1558944718810864] [PMID: 30428712]
[7]
Jackson WT, Viegas SF, Coon TM, Stimpson KD, Frogameni AD, Simpson JM. Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study. J Bone Joint Surg Am 1986; 68(6): 923-6.
[http://dx.doi.org/10.2106/00004623-198668060-00016] [PMID: 3733780]
[8]
Harvey FJ, Harvey PM, Horsley MW. De Quervain’s disease: Surgical or nonsurgical treatment. J Hand Surg Am 1990; 15(1): 83-7.
[http://dx.doi.org/10.1016/S0363-5023(09)91110-8] [PMID: 2299173]
[9]
Witt J, Pess G, Gelberman RH. Treatment of de Quervain tenosynovitis. A prospective study of the results of injection of steroids and immobilization in a splint. J Bone Joint Surg Am 1991; 73(2): 219-22.
[http://dx.doi.org/10.2106/00004623-199173020-00010] [PMID: 1993717]
[10]
de Quervain F. On a form of chronic tendovaginitis by Dr. Fritz de Quervain in la Chaux-de-Fonds. 1895. Am J Orthop (Belle Mead NJ) 1997; 26(9): 641-4.
[PMID: 9316729]
[11]
Kutsumi K, Amadio PC, Zhao C, Zobitz ME, An KN. Gliding resistance of the extensor pollicis brevis tendon and abductor pollicis longus tendon within the first dorsal compartment in fixed wrist positions. J Orthop Res 2005; 23(2): 243-8.
[http://dx.doi.org/10.1016/j.orthres.2004.06.014] [PMID: 15734232]
[12]
Rousset P, Vuillemin-Bodaghi V, Laredo JD, Parlier-Cuau C. Anatomic variations in the first extensor compartment of the wrist: Accuracy of US. Radiology 2010; 257(2): 427-33.
[http://dx.doi.org/10.1148/radiol.10092265] [PMID: 20829530]
[13]
Goyal A, Srivastava DN, Ansari T. MRI in De Quervain Tenosynovitis: Is making the diagnosis sufficient? AJR Am J Roentgenol 2018; 210(3): W133-4.
[http://dx.doi.org/10.2214/AJR.17.19078] [PMID: 29469625]
[14]
Kim KH, Byun EJ, Oh EH. Ultrasonographic findings of superficial radial nerve and cephalic vein. Ann Rehabil Med 2014; 38(1): 52-6.
[http://dx.doi.org/10.5535/arm.2014.38.1.52] [PMID: 24639926]
[15]
Lee Dellon A, Mackinnon SE. Radial sensory nerve entrapment in the forearm. J Hand Surg Am 1986; 11(2): 199-205.
[http://dx.doi.org/10.1016/S0363-5023(86)80051-X] [PMID: 3958447]
[16]
Serçe A, Karaca Umay E, Karaahmet ÖZ. Çakcı FA. An unexpected side effect: Wartenberg’s syndrome related to the use of splint during carpal tunnel syndrome treatment. Turk J Phys Med Rehabil 2017; 64(1): 83-6.
[http://dx.doi.org/10.5606/tftrd.2018.1186] [PMID: 31453494]
[17]
Lanzetta M, Foucher G. Entrapment of the superficial branch of the radial nerve (Wartenberg’s syndrome). Int Orthop 1993; 17(6): 342-5.
[http://dx.doi.org/10.1007/BF00180450] [PMID: 8163306]
[18]
Lanzetta M, Foucher G. Association of Wartenberg’s syndrome and De Quervain’s disease: A series of 26 cases. Plast Reconstr Surg 1995; 96(2): 408-12.
[http://dx.doi.org/10.1097/00006534-199508000-00023] [PMID: 7624415]
[19]
Peters-Veluthamaningal C, Winters JC, Groenier KH, Meyboom-deJong B. Randomised controlled trial of local corticosteroid injections for de Quervain’s tenosynovitis in general practice. BMC Musculoskelet Disord 2009; 10(1): 131.
[http://dx.doi.org/10.1186/1471-2474-10-131] [PMID: 19860883]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy