A 38-year-old woman presents with pain over the radial styloid for 3 months, worse with thumb movement. Finkelstein test is positive. She has failed 6 weeks of splinting and one corticosteroid injection. The next recommended step is:

• A Repeat corticosteroid injection
• B Radial styloidectomy
• C Extensor pollicis brevis tenotomy
• D Surgical release of the first dorsal compartment ✓

Explanation

De Quervain's tenosynovitis that fails conservative management (splinting, one to two corticosteroid injections) is treated with surgical release of the first dorsal compartment containing the APL and EPB tendons. Attention must be paid to protect the superficial radial nerve. Radial styloidectomy is not indicated.

Reference: Green's Operative Hand Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.