Ultrasound of de Quervain’s Tenosynovitis

What this episode covers

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/

Distinct summary based on available episode metadata or transcript content.