page_title: De Quervain syndrome
section_title: Pathophysiology
hierarchical_section_title: De Quervain syndrome / Pathophysiology
context_page_description: De Quervain syndrome is inflammation of two tendons that control movement of the thumb and their tendon sheath. This results in pain at the outside of the wrist. Pain is typically increased with gripping or rotating the wrist. The thumb may also be difficult to move smoothly. Onset of symptoms is gradual.
  Risk factors include certain repetitive movements, trauma, and rheumatic diseases. The diagnosis is generally based on symptoms and physical examination. Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist.
  Treatment involves avoiding activities that bring on the symptoms, pain medications such as NSAIDs, and splinting the thumb. If this is not effective steroid injections or surgery may be recommended. The condition affects about 0.5% of males and 1.3% of females. Those who are middle aged are most often affected. It was first described in 1895 by Fritz de Quervain.
context_section_description: De Quervain syndrome involves noninflammatory thickening of the tendons and the synovial sheaths that the tendons run through. The two tendons concerned are those of  the extensor pollicis brevis and abductor pollicis longus muscles. These two muscles run side by side and function to bring the thumb away from the hand; the extensor pollicis brevis brings the thumb outwards radially, and the abductor pollicis longus brings the thumb forward away from the palm. De Quervain tendinopathy affects the tendons of these muscles as they pass from the forearm into the hand via a fibro-osseous tunnel (the first dorsal compartment).
  Evaluation of histopathological specimens shows a thickening and myxoid degeneration consistent with a chronic degenerative process, as opposed to inflammation. The pathology is identical in de Quervain seen in new mothers.
caption: The mucous sheaths of the tendons on the back of the wrist.
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