Characteristic complaint of de Quervain's tenosynovitis

A 42-year-old carpenter presents with wrist pain and grip weakness. On exam he is found to have pain over the radial aspect of the wrist that is aggravated by flexing the thumb and applying ulner flexion. The most likely diagnosis is

• A) carpal tunnel syndrome
• B) scaphoid fracture
• C) de Quervain's tenosynovitis
• D) boxer's fracture
• E) hamate fracture

Answer and Discussion

The answer is  ( C ).
The combination of wrist pain and grip weakness is characteristic of de Quervain's tenosynovitis. The pain is generally located on the radial aspect of the wrist and reproduced with direct palpation of the involved tendons. Pain is aggravated by passively stretching the thumb tendons over the radial styloid in thumb flexion (the Finkelstein maneuver).