» Symptoms & Signs
Pain over the thumb-side of the wrist is the main symptom. The pain may appear either
gradually or suddenly, and pain is located at the first dorsal compartment (see Figure 1, 1A)
at the wrist. Pain may radiate down the thumb or up the forearm. Hand and thumb motion
increases pain, especially with forceful grasping or twisting. Swelling over the base of the
thumb may include a fluid-filled cyst in this region. There may be an occasional "catching"
or "snapping" when moving the thumb. Because of the pain and swelling, motion such as
pinching may be difficult. Irritation of the nerve lying on top of the tendon sheath may cause
numbness on the back of the thumb and index finger.
Diagnosis
Tenderness directly over the tendons on the thumb-side of the wrist is the most common
finding. A test is generally performed in which the patient makes a fist with the fingers
clasped over the thumb. The wrist is then bent in the direction of the little finger.
This maneuver can be quite painful for the person with de Quervain's tendonitis.
