J Am Acad Orthop Surg 2001;9(4):246-52; Clin Sports Med 1992;11:77

Cause:Overuse

Pathophys:Tenosynovitis of tendons in 1st dorsal wrist compartment: one/both of extensor pollicus longus/brevis

Common in occupational setting, throwers, racket sports

Sx:Pain with gripping, lifting, movement of thumb; may have audible “squeak”

Si:TTP radial side of wrist, pos Finklestein’s test (pain with flexion of thumb under clenched fingers with ulnar deviation at wrist)

Gradual or acute onset, usually associated with increase in activities involving wrist motion

May become chronic if untreated

Rx:

Initially, anti-inflammatory modalities. Immobilize in thumb spica wrist splint. PT necessary to increase strength, ROM after acute inflammation resolved. Surgical synovectomy only in extreme resistant cases