Workup
Radiography
Although the thickened first dorsal compartment can be bony hard, the thickening is made up of fascia and tendon. Radiographs are negative and are not necessary for routine diagnosis. However, it should be emphasized that radiographs should be obtained to rule out other conditions that may be responsible for the patient's pain.
Radiographs may be helpful in differentiating the patient who has de Quervain tenosynovitis from one who has osteoarthritis at the thumb carpometacarpal (CMC) joint or who is suffering from both conditions.
Media Gallery
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In de Quervain tenosynovitis, the first dorsal compartment is thickened, raising the skin and creating a prominence at the radial styloid.
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The Finkelstein test draws the tendons of the first dorsal compartment distally and causes sharp, local pain when tendon entrapment has occurred and inflammation is present.
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