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Monday, August 17, 2009

Pain by the side of wrist

Posted by Prahallad Panda on 7:31 PM 1 comments





Finkelstein's test for DeQuervain's tenosynovitis

Finkelstein's test for DeQuervain's tenosynovitis

Pain by the outer side of wrist commonly seen in middle aged women more often than their male counterparts.Medically this is a sort of disease to spot the diagnosis.The affected person is unable to hold something tightly.If tries to do that gets pain along the muscle of that side of forearm.It is painful  if pressure applied on that point.
  This is called De Quervain's disease .This is a sort of entrapment of the pulley called tendon to the thumb responsible for outward movement of it.It is diagnosed clinically basing mainly on two tests.First there is pain on pressure over the outer side of wrist where the bone called radius ends.In the second test patient gets pain when asked to clinch a fist with thumb pressing  all other fingers and patient asked to deviate the wrist outwards  away from the side of pain.That puts unusual stress on the outer muscle and patients gets pain.
   The treatment comprises rest to the wrist,moist heat application and prescription of simple analgesics.If no response is seen local infiltration of steroid is done.Usually that cures  many but some times a second or third injection may be needed in a few patients.The side effect being discolorization of skin in some, otherwise it is effective.
  The last option is surgery intended to release the entrapped tendon.Here care is taken not to damage the superficial small nerves to skin and minute blood vessels to the finger.The limb is immobilized for sometime, antibiotic and  analgesics  are prescribed for a few days.Hand is kept elevated to reduce pain.Early physiotherapy is instituted after removal of sutures.And the De Quervain's disease is gone.


Artwork on Lingaraj temple Bhubanaswar

Image via Wikipedia




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