Question

a 55 - year - old female presents with pain and swelling at the base of her thumb, which is exacerbated by activities involving grasping and pinching. on physical examination, there is tenderness over the radial styloid process, and finkelsteins test elicits sharp pain with ulnar deviation of the wrist. which of the following is the most likely diagnosis?
a carpal tunnel syndrome
b trigger finger
c de quervains tenosynovitis
d cubital tunnel syndrome

Explanation:

De Quervain's tenosynovitis is characterized by pain and swelling at the base of the thumb (radial styloid process area). Activities involving grasping and pinching (common hand - thumb motions) exacerbate the symptoms. Finkelstein's test is a specific test for De Quervain's tenosynovitis. In this test, ulnar deviation of the wrist (with the thumb tucked in) elicits sharp pain.

• Carpal tunnel syndrome typically presents with median nerve distribution symptoms (numbness, tingling in the hand, especially the palmar side of the first three and a half fingers).
• Trigger finger is a condition of the flexor tendons of the fingers, causing a catching or locking sensation when bending/straightening the finger.
• Cubital tunnel syndrome is related to the ulnar nerve at the elbow, with symptoms in the ulnar nerve distribution (numbness, tingling in the fourth and fifth fingers, etc.).

Answer:

C. De Quervain's tenosynovitis