You can find different problems seen in a rheumatologist’s office that can cause thumb discomfort.
Probably the most common is what is called De Quervain’s tenosynovitis. This kind of tendinitis is a result of repetitive motion involving the thumb. Actions such as using pruning shears, creating, pinching, knitting, lifting weights, and typing can cause this.
Another situation is that of new mothers.
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Because of the repetitive movement involved in lifting and carrying a baby, new mothers can also develop this problem.
Symptoms of De Quervain’s include swelling, pain, and tenderness involving the radial (thumb side) of the wrist plus thumb. The pain can be so severe that the patient cannot use their thumb at all.
On examination, there is tenderness noted along the thumb side of the wrist. Also, there is an optimistic Finkelstein’s maneuver. The physician has the affected person bring the thumb across the palm from the hand. Then the patient is inquired to fold their fingers on the thumb. The hand is after that pushed towards the little finger part of the wrist. This stretches the tendons along the thumb side from the wrist and causes severe pain.
While the diagnosis is often made upon clinical grounds, it can be confirmed simply by either diagnostic ultrasound or magnetic resonance imaging (MRI).
There is a basic reason for making sure the diagnosis is correct. That reason is because there is another type of tendinitis that looks like Sobre Quervain’s tendinitis. This condition is called intersection syndrome.
Intersection syndrome involves muscles that are very near the tendons that cause De Quervain’s disease. Intersection syndrome also arises from repetitive motion and is often seen in very active people.
One other condition that can be baffled with De Quervains disease will be osteoarthritis at the base of the thumb. Location of symptoms is very comparable in both conditions.
One other type of tendonitis can occur on the palm side from the thumb. This is called stenosing tenosynovitis- or” trigger thumb. ” The sufferer may have difficulty bending and straightening their thumb because it catches.
When the diagnosis of DeQuervain’s disease or intersection syndrome is established, treatment of this set associated with conditions- which are considered forms of arthritis- can begin. Treatment of these disorders consist of splinting, anti-inflammatory medication, physical therapy, and sometimes, corticosteroid injection. Anabolic steroid injection should be administered using ultrasound guidance. This usually provides speedy relief.
In those patients who do not respond to the above measures, hook tenotomy with platelet rich lcd (PRP) administration using ultrasound assistance is often each effective.
For trigger thumb, steroid injection usually functions. In those patients who always trigger, a release of the small pulley that causes trapping of the browse tendon can be accomplished using a little needle with ultrasound guidance. Within rare instances, open surgery is needed.