Authors: Prashant Kaushik, Mark L Riley, Tina P Kunnath, Neal Rajyaguru, Aadya Kaushik BS Candidate.
Musculoskeletal ultrasound (MSUS) has emerged as an optimal modality for diagnostic and therapeutic injections to the wrist region. de Quervain’s tenosynovitis/retinaculitis (DQR) is a common condition of the wrist caused by stenosing tenosynovitis of the first dorsal compartment involving the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. DQR is routinely diagnosed with Finkelstein’s test and the wrist hyperflexion and
abduction of the thumb (WHAT) test. These tests have high sensitivity, but low specificity. We present the case of a 70-year-old male with a history ofseronegative rheumatoid arthritis and a two-week history of right wrist pain. Finkelstein and WHAT tests were positive. Point-of-care application of MSUS demonstrated inflammation in the first dorsal compartment involving the APL and EPB tendons indicating a diagnosis of DQR. MSUS-guided corticosteroid injection of the involved tendons resulted in complete resolution of the pain.