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Family physicians are well-positioned to provide injections for patients who have wrist pain, especially when initial treatments such as nonsteroidal anti-inflammatory drugs and rest fail. Although corticosteroid injections can offer pain relief, possible risks (e.g., infection, cartilage damage, skin depigmentation) should be discussed. Techniques and procedures for injections vary. Studies have shown significant improvement in carpal tunnel syndrome severity over 12 weeks using ultrasound-guided injections compared with landmark-guided injections. Ganglion cyst aspiration can be helpful for patients with significant symptoms, although more than 50% of ganglion cysts may recur within a year. Corticosteroid injections of ganglion cysts do not appear to produce additional benefits to aspiration. Intersection syndrome is an overuse injury; management involves rest, adjustment of activities, use of braces, nonsteroidal anti-inflammatory drugs, and physical or occupational therapy. For symptoms not improved by these methods, an ultrasound-guided glucocorticoid injection may be administered. Treatment options for a triangular fibrocartilage complex injury include immobilization, kinesio taping, relative rest, and analgesics; corticosteroid injection may relieve acute inflammatory pain. De Quervain tenosynovitis is treated conservatively with palpation- or ultrasound-guided corticosteroid injection, splinting, occupational therapy, and activity modification. [ABSTRACT FROM AUTHOR]

BACKGROUND: De Quervain's tenosynovitis is upper-limb disorder, more frequent in women. It is rarely recognized as an occupational disease. OBJECTIVE: In this paper we reported work related de Quervain's tenosynovitis in cow milker. METHODS: Ergonomic risk factors were assessed by utilizing assessment of repetitive tasks (ART) of the upper limbs method. Physical examination and imaging exams were used. RESULTS: We presented a 36-year-old female agricultural worker (workplace cow milker) exposed to work factors (forceful hand/wrist exertions, repetition, extreme postures) for 14 years. She was suffering the pain in the right hand, mainly near the thumb for few years. She was treated conservatively and surgically, however disability was permanent. Clinical examination showed slight edema of the right hand, increased palm's sweating. Patient had reduced range of movements and grip strength. CONCLUSIONS: Report shows that work-related factors were strongly associated with diagnosed de Quervain's tenosynovitis. Hand function plays an essential role in carrying out activities of daily living and this disorder pose a relevant burden of disease. Exposure to biomechanical factors should be an important initial target for the prevention of De Quervain's tenosynovitis in the working population. [ABSTRACT FROM AUTHOR]

Background De Quervain's tenosynovitis (DQt) is a prevalent chronic inflammatory musculoskeletal disorder predominantly affecting the radial aspect of the wrist. This study conducted a comprehensive review of the efficacy of acupuncture in treating De Quervain's tenosynovitis (DQt). Although there is evidence suggesting that acupuncture can alleviate symptoms of DQt–characterized by pain, swelling, and functional impairment–higher-level evidence is still required to further substantiate its efficacy and safety. This study conducted a comprehensive review of the efficacy of acupuncture in treating De Quervain's tenosynovitis (DQt). Methods By systematically searching databases such as PubMed, Science Direct, Web of Science, Google Scholar, EMbase, PEDro, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chongqing VIP China Science, Technology Journal Database (VIP), we retrieved randomized controlled trial (RCT) literature on acupuncture for DQt, with the search period extending to November 1, 2023. After extracting and assessing data from the included literature, we performed Meta-analysis using RevMan 5.4.1 software. Results The results encompassed 14 RCT papers, involving 851 patients. The Meta-analysis findings indicated that, when compared to topical analgesics, acupuncture demonstrated a significant increase in treatment effectiveness (RR = 1.24; 95% CI = 1.11, 1.39, P  = 0.0002) and a notable reduction in VAS pain scores (MD = −1.06; 95% CI = −1.51, −0.61, P  < 0.00001). However, no statistically significant difference was observed in conney wrist joint scores. Furthermore, acupuncture was found to reduce VAS pain scores compared to the waiting list group. In comparison to corticosteroid injections (CSI), acupuncture did not show statistical significance in VAS, effectiveness rate, and conney wrist scores. Conclusion Acupuncture exhibited a promising trend in alleviating pain associated with DQt and enhancing treatment effectiveness. Nonetheless, due to limitations in the quantity and quality of the included studies, these findings warrant further validation through additional research. [ABSTRACT FROM AUTHOR]

Hand tendinopathies represent a pathological condition associated with significant disability. However, due to this high heterogeneity of the treatments and their efficacy, there is still a lack of consensus on the infiltrative therapy of the hand. This systematic review aimed to investigate the efficacy of injection techniques in the treatment of pain related to the main hand tendinopathies. We searched online medical databases (PubMed, Pedro, Cochrane Library, Scopus, and WoS). Only RCTs published in the last 10 years (up to 5 August 2024), written in English, and related to infiltrative treatment in wrist and hand tendinopathies were evaluated. The risk of bias in RCTs was assessed with Version 2 of the Cochrane Risk of Bias tool for randomized trials (RoB 2). Out of 641 articles identified, 23 were included in the final synthesis: 14 RCTs on trigger finger, and 9 RCTs on de Quervain's tenosynovitis. The present systematic review showed that infiltrative therapy of trigger finger and de Quervain's tenosynovitis constitutes a fundamental element in the treatment of these pathological conditions, in terms of pain reduction and improvement in the functionality of the hand. [ABSTRACT FROM AUTHOR]

The document titled "Photobiomodulation Literature Watch October 2023" is a valuable resource for researchers and individuals interested in the field of photobiomodulation therapy. It provides a list of recent research articles on the topic, covering a range of subjects such as wound healing, pain management, oral mucositis, neurogenesis, and cognitive impairment. The studies explore the effectiveness of photobiomodulation therapy using low-level light therapy, laser acupuncture, and therapeutic lasers in various medical conditions. This document offers a comprehensive overview of the current research in the field of photobiomodulation therapy. [Extracted from the article]

Objective: To assess the prevalence of De Quervain's tensosynovitis among smart phone users caused by excessive text messaging in undergraduate students of Gujranwala. Study Design: Cross Sectional study. Setting: Data was collected from different Institutes of Gujranwala City in the Institutes i.e. Elite College Gujranwala, Gujranwala Institute of Medical Sciences, Gujranwala Medical College, and Degree College Gujranwala. Period: 01-01-2022 to 30-06-2022. Methods: Institutes were selected by convenience sampling technique. 8 male and 12 female institutes were selected. The sample size at the time of study were 300. In this investigation, non-probability convenience sampling technique was used. Results: Results show that youngsters using smartphone frequently showed more positive result for Dequervain tenosynovitis (Finkelstein test p-value < 0.05). Conclusion: De Quervain's tenosynovitis is most prevalent among females. People with the age group of 20-21 are most effected as compared to the other age groups. Because of their repetitive usage of smartphone experiencing ache and weakness over the base of pollex or wrist. There seems to be a direct link among heavy text communications on a smartphone and prevalence of Dequervain tenosynovitis. [ABSTRACT FROM AUTHOR]

Background Endoscopy-related musculoskeletal injuries (ERIs) are commonly reported but their exact prevalence and clinical impact remain obscure. We conducted a systematic review and meta-analysis of the current literature aiming to answer these questions. Methods The MEDLINE, EMBASE, and SCOPUS databases were searched for studies evaluating ERIs in gastroenterologists and surgeons. The co-primary outcome was the prevalence of ERIs (i.e. carpal tunnel syndrome, de Quervain's tenosynovitis, and hand numbness). The second co-primary outcome was the prevalence of endoscopy-related pain syndromes. Results 12 studies, including 4563 respondents, were included. The majority of respondents were men (n = 3321; 72.8%) and most were right-handed (86.2%). The career prevalence of carpal tunnel syndrome (pooled from 10 studies) was 5.3% (95%CI 1.5%–8.9%; I2 = 97.1%), while the prevalence of de Quervain's tenosynovitis (five studies) was 8.5% (95%CI 0.1%–17.0%). The pooled prevalences of thumb pain, neck pain, and back pain were 25.4%, 23.1%, and 19.7%, respectively, but the prevalence varied according to the type of questionnaire used. Only 341/864 respondents (39.5%) had received prior training in ergonomics, while 623/889 respondents (70.1%) expressed a desire for further training in ergonomics. Overall, there is a moderate risk of bias in the present literature. Conclusion ERIs, including carpal tunnel syndrome, de Quervain's tenosynovitis, and endoscopy-related pain, are very common. These injuries can be severe, requiring surgery, and lead to loss of productivity. Most gastroenterologists report an unmet need for training in the proper ergonomics of endoscopy. [ABSTRACT FROM AUTHOR]

Abstract Background In Bangladesh, the most prevalent musculoskeletal condition among office employees is considered as BlackBerry thumb (BBT). Alike official perspectives, our educational system was significantly regulating with the digital interfaces at COVID-19 lockdown, where a greater reliance on Android phones were experienced among the adults. Numerous studies have been conducted in studying the incidences of BBT in young individuals as a result of hazards of Android phone usage (HAPU) in Bangladesh. Objective This research sought to determine the relationship between BBT symptoms and the risks associated with the using Android phones among Bangladeshi university students. Methods A nationwide cross-sectional study was undertaken on a group of university students between the ages of 18 and 25 to determine if BBT symptoms were present based on the Finkelstein test and HAPU, which were also assessed using a well-designed questionnaire. We calculated the crude and adjusted prevalence ratios (aPR) and used a generalized linear model from the Poisson family, using their respective 95% confidence intervals (CI). Results There were 2455 individuals in this research, with a median age of 20 and an interquartile range (IQR) of 19 to 23. Of them, 1185 males (48.27%) and 1270 women (51.75%) made up the study’s participant population. Physical exams showed that 1300 individuals had positive Finkelstein test results (52.95%), whereas 1040 people had occasional risks from using an Android phone and 115 participants had occasional risks from using an iPhone. In our generalized linear model, we observed that participants with occasional and frequent HAPU had higher rates of BBT symptoms than responders without HAPU (aPR = 1.73, 95% CI: 1.47–2.05, and aPR = 1.61, 95% CI: 1.29–2.00), respectively. Conclusion The current study found that Bangladeshi university students experiencing BlackBerry thumb symptoms were more likely to have risks associated with using Android phones.

This study investigates the predictive value of preoperative ultrasonography for the presence of an intracompartmental septum and the effect of a septum on clinical outcomes and complications in patients who underwent endoscopic first extensor compartment release for de Quervain's syndrome. A total of 170 patients (181 wrists) were examined, and a septum was present in 118 (69%) patients. The sensitivity and specificity of the preoperative ultrasonography were 88% and 94%, respectively. Patients were assessed at a minimum of 12 months after endoscopic release. The Disabilities of Arm, Shoulder and Hand score (54 to 4.2), visual analogue scale pain score (8.0 to 1.0) and pinch strength (2.3 to 3.2 kg) were significantly improved compared to the preoperative status (p < 0.001). There were no significant differences in clinical outcomes or complications between patients with and without a septum. Level of evidence: IV [ABSTRACT FROM AUTHOR]

Background: In Bangladesh, the most prevalent musculoskeletal condition among office employees is considered as BlackBerry thumb (BBT). Alike official perspectives, our educational system was significantly regulating with the digital interfaces at COVID-19 lockdown, where a greater reliance on Android phones were experienced among the adults. Numerous studies have been conducted in studying the incidences of BBT in young individuals as a result of hazards of Android phone usage (HAPU) in Bangladesh. Objective: This research sought to determine the relationship between BBT symptoms and the risks associated with the using Android phones among Bangladeshi university students. Methods: A nationwide cross-sectional study was undertaken on a group of university students between the ages of 18 and 25 to determine if BBT symptoms were present based on the Finkelstein test and HAPU, which were also assessed using a well-designed questionnaire. We calculated the crude and adjusted prevalence ratios (aPR) and used a generalized linear model from the Poisson family, using their respective 95% confidence intervals (CI). Results: There were 2455 individuals in this research, with a median age of 20 and an interquartile range (IQR) of 19 to 23. Of them, 1185 males (48.27%) and 1270 women (51.75%) made up the study's participant population. Physical exams showed that 1300 individuals had positive Finkelstein test results (52.95%), whereas 1040 people had occasional risks from using an Android phone and 115 participants had occasional risks from using an iPhone. In our generalized linear model, we observed that participants with occasional and frequent HAPU had higher rates of BBT symptoms than responders without HAPU (aPR = 1.73, 95% CI: 1.47–2.05, and aPR = 1.61, 95% CI: 1.29–2.00), respectively. Conclusion: The current study found that Bangladeshi university students experiencing BlackBerry thumb symptoms were more likely to have risks associated with using Android phones. [ABSTRACT FROM AUTHOR]

Knowledge of the superficial radial nerve (SRN) relationship and anatomic variations of the first extensor compartment (1st EC) will contribute to a better outcome of de Quervain tenosynovitis treatment. We dissected 87 embalmed cadaveric wrists to determine the relationship of the SRN, the 1st EC length, distance from the proximal and distal 1st EC borders to radial styloid process (RSP), abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slip numbers, and the presence of septum. Our results revealed SRN crossing over the 1st EC in 59.5%. The lateral branch of the superficial radial nerve to the 1st EC midline in most cases (61.9%) except for one specimen, where lateral antebrachial cutaneous nerve was the closest. Distances from proximal and distal 1st EC borders to the RSP were 19.7±4.1 mm and 7.6±1.8 mm, respectively. Extensor retinaculum (ER) width over 1st EC (1st EC length) was 14.8±3.2 mm. Complete and incomplete septa were found in 17.2%, and 42.5%, respectively. The most frequent APL tendon slip number in the compartment was two in overall 47 specimens (54.0%). Almost all compartments (85 specimens; 97.7%) contained one EPB tendon slip. We detected bilateral EPB absence in one cadaver. Moreover, we recorded a tendon slip from extensor pollicis longus traveling into 1st EC bilaterally in one cadaver and observed the EPB muscle belly extension into 1st EC in 9 wrists. Awareness of 1st EC anatomic variations would be essential for successful surgical and nonsurgical outcomes. [ABSTRACT FROM AUTHOR]

This article discusses a minimally invasive ultrasonography (US)-guided thread-release technique for decompressing the first extensor compartment of the hand. The technique was evaluated for its effectiveness and safety in a study using cadaveric hands. The results showed that a complete release was achieved in 18 out of 20 cases, with minimal damage to the tendons and no harm to neurovascular structures. The authors conclude that US-guided thread release is a reliable and safe method for treating De Quervain's tenosynovitis. [Extracted from the article]

Background: De Quervain (DQ) disease is caused by stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis. This condition affects women 6 times more than men and is also commonly reported in pregnant and lactating women. The natural course of the disease and associated risk factors are not well understood. In this study, we described the gestational risk factors associated with postpartum DQ. Methods: Sixty-three postpartum women with DQ were included in final study population. Medical records were reviewed for patient characteristics, including age, comorbidities, and body mass index (BMI), and gestational information, including length of pregnancy, gestation number, single or twin birth, and weight at birth. Odds ratio (OR) for developing DQ tenosynovitis were calculated with the control group of 630 postpartum women without DQ who gave birth between 2012 and 2020 in the same district. Results: Length of pregnancy (>40 weeks, OR = 5.81 [3.29-10.28]), first childbirth (OR = 2.23 [1.32-3.77]), and weight (BMI > 25, OR = 2.08 [1.14-3.81]) were all statistically significant risk factors associated with developing DQ. Number of fetuses > 1 (OR = 0.98 [0.29-3.33]) and birth weight more than 3.5 kg (OR = 0.60 [0.30-1.21]) were not associated with higher risk of DQ. Conclusions: Gestational risk factors associated with developing postpartum DQ include first pregnancy and long pregnancy of more than 40 weeks. Interestingly, child's birthweight and number of fetuses, both factors that might increase load on the first dorsal compartment while holding the child, were not shown to increase the risk of postpartum DQ. [ABSTRACT FROM AUTHOR]

Pectoralis major tendon tears were discussed, including an overview of the muscle and tendon anatomy, the clavicular head and sternal head of the muscle, and the U-shaped tendon. It is evident that distinct textures, which are predominantly present in tendinopathic tendons, appear most commonly near the transverse boundary of the tendon, though there was a large variability among diseased tendons. Flexor tendon pathologies include tenosynovitis, open and closed tendon rupture, pulley and volar plate injuries, and tumours of the tendon sheath. The 4 bicep tendons Dr James Hodgkinson I Perth Radiological Clinic, Perth i I , i I Western Australia i Dr Hodgkinson gave a detailed anatomy and imaging summary of the tendons of biceps brachii, with discussion of relevant pathologies. [Extracted from the article]

Common wrist conditions include fractures and other injuries, osteoarthritis, radial epiphysitis, joint instability, de Quervain tenosynovitis, carpal tunnel syndrome, ganglion cyst, and ulnar neuropathy. The initial history and physical examination, with particular focus on the anatomic structures of the wrist, can narrow the differential diagnosis. Magnetic resonance imaging study can be used to identify soft tissue masses and occult osseous processes, particularly with scaphoid fractures. Computed tomography scan is useful in cases of bony abnormalities, high clinical suspicion of occult fracture, and surgical planning. Musculoskeletal ultrasonography can help identify soft tissue injuries, synovitis, or edema. It also can assess for nerve pathology, such as increased median nerve surface area in carpal tunnel syndrome. Management of common wrist fractures, such as distal radius, carpal, and scaphoid fractures, includes nonsurgical and surgical options, immobilization, and referral for further management or surgical consultation. Other wrist conditions, including overuse conditions such as carpometacarpal osteoarthritis or radial epiphysitis, can be managed conservatively initially. Ganglion cysts can be managed with immobility and rest initially, or aspiration or surgical excision. Ulnar neuropathy is the result of local compression of the ulnar nerve at the level of the carpal bones. It typically is managed with activity modification and splinting. [ABSTRACT FROM AUTHOR]

Background: The growing prevalence of smartphone use among college students in China has led to health concerns, including De Quervain's Tenosynovitis (DQT). However, the specific smartphone usage behaviors contributing to DQT remain poorly understood. This study aimed to explore the relationship between smartphone usage behaviors and DQT in college students. Methods: A cross-sectional study was conducted with 937 students from various majors in Guangxi between September 2021 and April 2022. Participants completed an online questionnaire assessing smartphone usage behaviors and their association with DQT. The Finkelstein test was employed to diagnose DQT. Results: Over half of the college students (52%) tested positive for DQT via Finkelstein's test. Higher levels of smartphone usage time (6–8 h/day: OR = 4.454, 95%CI:1.662–12.229; ≥8 h/day: OR = 4.521, 95%CI:1.596–12.811), phone games (OR = 1.997, 95%CI:1.312–3.040), social media (OR = 2.263, 95%CI:1.795–3.833), and leisure activities (OR = 1.679, 95%CI:1.140–2.475) were significantly associated with an increased risk of DQT. Two specific gestures (Bilateral thumbs, BT: OR = 1.900, 95%CI:1.281–2.817; Bilateral thumbs-horizontal screen, BT-HS: OR = 1.872, 95%CI:1.244–2.818) and two screen sizes (5.0-5.5inch: OR = 2.064, 95%CI:1.108–3.846; 6.0-6.5inch: OR = 2.413, 95%CI:1.125–4.083) also exhibited a higher risk of DQT. Bilateral DQT was observed, with Gesture-BT identified as the primary risk factor. Conclusion: Our findings suggest that increased smartphone usage time, phone games, social media, and leisure activities elevate the risk of DQT among college students. Furthermore, two specific gestures and two screen sizes were also linked to a heightened DQT risk. To mitigate DQT development, college students should reduce smartphone usage time and adopt appropriate gestures. [ABSTRACT FROM AUTHOR]

Background Steroid injection and splinting, which are commonly recommended nonsurgical treatments in adults with trigger finger, have been demonstrated to effectively relieve pain and improve function. However, to our knowledge, there have been no direct comparisons of pain relief and function improvement with splinting alone, steroid injection alone, or a combination of splinting and steroid injection in patients with this diagnosis. Question/purpose Are there differences in pain reduction and functional improvement in adults with trigger finger treated with splinting alone, steroid injection alone, and a combination of splinting and steroid injection at 6, 12, and 52 weeks after the intervention? Methods Between May 2021 and December 2021, we treated 165 adult patients for trigger finger at an academic university hospital. Based on prespecified criteria, all patients we saw during that period were eligible, but 27% (45 of 165) were excluded because they had received a previous local corticosteroid injection (n = 10) or they had concomitant carpal tunnel syndrome (n = 14), first carpometacarpal joint arthritis (n = 3), osteoarthritis of the hand (n = 6), de Quervain disease (n = 3), multiple-digit trigger finger (n = 6), or pregnancy during the study period (n = 3). After screening, 120 patients were randomized to receive either splinting (n = 43), steroid injection (n = 40), or splinting plus steroid injection (n = 37). Patients were randomly assigned to the different treatments using computer-generated block randomization (block of six). Sequentially numbered, opaque, sealed envelopes were used in the allocation concealment process. Both the allocator and the outcome assessor were blinded. Splinting involved the patient wearing a fixed metacarpophalangeal joint orthosis in the neutral position at least 8 hours per day for 6 consecutive weeks. Steroid injection was performed using 1 mL of 1% lidocaine without epinephrine and 1 mL of triamcinolone acetonide (10 mg/mL) injected directly into the flexor tendon sheath.No patientswere lost to follow-up or had treatment failure (that is, the patient had persistent pain or triggering with the trigger finger treatment and requested additional medical management including additional splinting, steroid injection, or surgery) at 6 or 12 weeks after the intervention, and at 52 weeks, there was no difference in loss to follow-up among the treatment groups. An intention-totreat analysis was performed with all 120 patients, and a perprotocol analysis was conducted with 86 patients after excluding patients who were lost to follow-up or had treatment failure. Primary outcomes evaluated were VAS pain reduction and improvement in Michigan Hand Outcomes Questionnaire (MHQ) scores at 6, 12, and 52 weeks after the intervention. The minimum clinically important difference (MCID) values were 1 and 10.9 for the VAS and MHQ, respectively. Results There were no clinically important differences in VAS pain scores among the three treatment groups at any timepoint, in either the intention-to-treat or the per-protocol analyses. Likewise, there were no clinically important differences in MHQ scores at any timepoint in either the intention-to-treat or the per-protocol analyses. Conclusion Splinting alone is recommended as the initial treatment for adultswith trigger finger because therewere no clinically important differences between splinting alone and steroid injection alone in terms of pain reduction and symptom or functional improvement up to 1 year. The combination of steroid injection and splinting is disadvantageous because the benefits in terms of pain reduction and symptom or functional improvement are not different from those achieved with steroid injection or splinting alone. Level of Evidence Level I, therapeutic study. [ABSTRACT FROM AUTHOR]

Abstract Objective To evaluate the open surgical treatment for carpal tunnel syndrome as a risk factor for the development of stenosing tenosynovitis that results in trigger finger and De Quervain disease. Materials and Methods A retrospective study analyzing the medical records of patients submitted to open surgical release of carpal tunnel syndrome between 2010 and 2021 in a secondary- and tertiary-level hospital. The following data were collected: pathological history, duration of the follow-up after the surgical treatment for carpal tunnel syndrome, development of trigger finger or De Quervain tenosynovitis, affected fingers, and the interval between the end of surgery and symptom onset. Results We evaluated 802 patients of both genders and with a mean age of 50.1 (±12.6) years. The mean follow-up was of 13 (±16.4) months. The mean time until the development of trigger finger was of 61.4 months, and of 73.7 months for De Quervain disease. The incidence of development of De Quervain disease was of 4.12%, and for trigger finger it was of 10.2%. The most affected digits were the thumb (47.6%), the middle (24.4%), and the ring finger (8.54%). Age was the only factor that showed an association with the risk of developing trigger finger, with an increase of 2% for each increase in age of 1 year. Conclusion The incidence rates for the development of De Quervain disease (4.12%) and trigger finger (10.2%) after the surgical treatment for carpal tunnel syndrome were like those described in the literature. Only age was a factor that influenced the development of trigger finger.

The purpose of this study is to determine the additional effect of high-intensity laser therapy (HILT) when combined with therapeutic exercise and splinting in the treatment of patients diagnosed with de Quervain's tenosynovitis. Nineteen patients diagnosed with de Quervain's tenosynovitis were randomly divided into two groups: the HILT group and the sham HILT group. A total of 9 HILT or sham HILT sessions were administered, with 3 sessions per week for 3 consecutive weeks. Both groups received the thumb spica splint and therapeutic exercise. A comparison was conducted between the two groups, as well as pre- and post-treatment, focusing on the following outcomes: Visual Analog Scale (VAS) for pain, hand grip strength, and Thai version of Patient-Rated Wrist and Hand Evaluation (PRWHE-Thai) as a disability score. No significant differences were found between the HILT group and the sham group across all evaluated outcomes. However, when examining changes within each group over time, both the HILT and sham groups showed significant reductions in pain and improvements in disability score at the follow-up assessments compared to baseline. On the other hand, no statistically significant differences were observed in grip strength outcomes at any of the measured time points. The combination of HILT with a splint and exercise demonstrates effectiveness as a method for pain management and functional improvement in patients with subacute de Quervain's tenosynovitis. It is important to note that HILT does not offer any additional advantages when compared to the combined use of a splint and exercise. [ABSTRACT FROM AUTHOR]

The first extensor compartment of the wrist is a distinctly variable anatomical area. Anatomical variations in this region contribute to the pathophysiology and treatment failure of de Quervain’s disease, which is a kind of tenosynovitis that develops in the first extensor compartment of the wrist. We aim to describe the first extensor compartment morphology, to evaluate the septum frequency, location of the septum, and the number of tendons of abductor pollicis longus (APL) and extensor pollicis brevis muscles (EPB). First extensor compartment of 87 wrists of 45 cadavers were dissected. The presence or absence of septum and number of tendon slips of APL and EPB revealed. The proximal and distal widths of the compartments were measured. Septums were detected in 60.9% (n=53) of the wrists. Incomplete (distal) and complete (proximal) septa were present in 35.6% (n=31) and 25.3% (n=22) of the cases. Only 26.4% of the wrists had a single slip of APL tendon. The Remaining had multiple slips. The median inner width of the proximal and distal compartments in all wrists were calculated as in the order of 9.11±1.14 mm and 8.55±1.12 mm. We believe that understanding the anatomy of the first extensor compartment in the Turkish population would be helpful to surgeons, radiologists, and physiotherapists to diagnose and manage de Quervain’s disease. [ABSTRACT FROM AUTHOR]

A systematic review was conducted on studies reporting steroid injections with ultrasound for de Quervain. From 10 studies included and 379 wrists, 73.9% reported complete resolution of symptoms, 18.2% with partial and 7.9% without resolution. When compared to the landmark‐guided technique, ultrasound guidance showed significantly higher rates of symptom resolution (P = 0.0132) and lower pain scores (P < 0.0001). Twenty‐nine patients out of 163 who initially showed complete resolution of symptoms reported subsequent recurrence. We conclude that steroid injections guided by ultrasound present high rates of symptomatic relief through precise needle insertion, especially in cases of anatomic variability with subcompartments. [ABSTRACT FROM AUTHOR]

Aesthetics is a demanding and growing specialty. More providers are injecting daily at a high volume. De Quervain’s tenosynovitis (DQT) is a well-known syndrome involving the hand in the orthopedic and rehabilitation space. The prediction is that DQT will soon become well known to aesthetic injectors. DQT presents with swollen tendons that run along the thumb side of the wrist and attach to the base of the thumb. This is a result of repetitive motion or overuse of the thumb, most often of the dominant hand. This causes pain to the thumb and wrist area, making it difficult to complete daily tasks and perform injections on patients. Objective: This article’s goal is to increase awareness among providers of the signs and symptoms of DQT and to be proactive in preventing this condition. A home exercise program has been created to focus on strengthening and conditioning the hand of injectors. Methods: A systematic literature search of the PubMed database was completed. Results: There is a positive correlation between industry demand, increased daily injecting, and the probability of injectors developing DQT. The pain caused by this syndrome can affect the daily lives and work performance of injectors. Proper body ergonomics, including stretching and strengthening the thumb, can be used to reduce pain caused by DQT. Limitation: There was no case study or testing done on groups of people, which limits the results of this review. [ABSTRACT FROM AUTHOR]

Endoscopy-related musculoskeletal injuries are on the rise among endoscopists, with reports suggesting that 29% to 89% of endoscopists suffer from such problems. These injuries result from performing multiple endoscopic procedures daily, involving repetitive movements, awkward posture, and the handling of cumbersome tools. A systematic review and meta-analysis found that endoscopists commonly experience thumb, neck, and back pain, as well as serious injuries requiring surgery and leading to long-term disability. The American Society for Gastrointestinal Endoscopy (ASGE) has guidelines for ergonomics in endoscopy, but many endoscopists do not follow them. It is clear that more needs to be done to protect endoscopists from these injuries, including education, ergonomic improvements, and changes in clinical practice and hospital administration. [Extracted from the article]

Objectives: The pathology of de Quervain's disease affects the tenosynovium and rarely the tendons. The ultrasonographic features of de Quervain's disease unresponsive to conservative treatment are unknown. The purpose of this study was to describe and compare the morphological differences between patients with de Quervain's disease that is refractory to conservative treatment and patients who respond to conservative treatment. Methods: de Quervain's disease unresponsive to conservative treatment was evaluated in 51 patients. The bilateral wrists underwent preoperative ultrasonographic assessments. The asymptomatic side was presumed to be the patient's anatomical baseline and was used for comparison. We measured the diameter and cross‐sectional area of the tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB), and the thickness of the tendon sheath and the intercompartmental septum, if present. The affected side and asymptomatic side were compared. Results: The APL and EPB cross‐sectional area was significantly larger on the affected side than on the asymptomatic side (APL: 13 mm2 versus 8.3 mm2; P <.0001; EPB: 5.4 mm2 versus 3.9 mm2; P =.031). The tendon sheath was significantly thicker on the affected side (1.5 mm) than on the asymptomatic side (0.95 mm) (P <.0001). The intercompartmental septum was significantly thicker on the affected side (1.1 mm) than on the asymptomatic side (0.72 mm) (P =.0004). Operative findings revealed 41 (80%) patients had an intercompartmental septum. Conclusions: The ultrasonographic features of de Quervain's disease requiring surgical treatment were a significantly thickened tendon sheath, an intercompartmental septum, and increased cross‐sectional area of the APL and EPB. [ABSTRACT FROM AUTHOR]

This study investigated the association of de Quervain tenosynovitis (DQT) with subsequent adhesive capsulitis (AC) development. Patients with DQT between 2001 and 2017 from the Taiwan National Health Insurance Research Database were the DQT cohort. The 1:1 propensity score matching method was applied for creating control cohort. The primary outcome was defined as new-onset of AC at least 1 year after the date of confirmed diagnosis of DQT. In total, 32,048 patients with mean age 45.3 years were included. DQT was significantly positively associated with risk of new-onset AC after adjustment for baseline characteristics. Furthermore, severe DQT requiring rehabilitation was positively associated with risk of new-onset AC. In addition, male gender and age under 40 may be additional risk factors for new-onset AC, compared to female gender and age over 40. Cumulative incidence of AC after 17 years was 24.1% among patients with severe DQT requiring rehabilitation and was 20.8% among patients with DQT without rehabilitation. This is the first population-based study to demonstrate an association between DQT and new-onset AC. The findings recommend that preventive occupational therapy, including active modification for the shoulder joint and adjustments to daily activities, may be necessary for patients with DQT to reduce their risk of developing AC. [ABSTRACT FROM AUTHOR]

Introduction: de Quervain's syndrome is a painful condition commonly presented to hand therapists. Exercise is utilised as an intervention, but isometric exercise has not been investigated. We aimed to assess the feasibility and safety of isometric thumb extension exercise for de Quervain's syndrome and to explore differences between high-load and low-load isometric exercise. Methods: This parallel-group randomised clinical feasibility trial included individuals with de Quervain's syndrome. All participants underwent a 2 week washout period where they received an orthosis, education, and range of motion exercises. Eligible participants were then randomised to receive high or low-load isometric thumb extension exercises, performed daily for 4 weeks. Feasibility and safety were assessed by recruitment and drop-out rates, adherence, adverse events, and participant feedback via semi-structured interviews. Secondary outcomes included patient-reported outcomes for pain and function, and blinded assessment of range of motion and strength. Results: Twenty-eight participants were randomised. There were no drop-outs after randomisation, and no serious adverse events. Adherence to exercise was 86.7%, with 84% of participants stating they would choose to participate again. There were clinically and statistically significant improvements in pain and function over time (p < 0.001) but not in range of motion or strength. There were no statistically significant between-group differences. Conclusions: Isometric thumb extension exercise within a multimodal approach appears a safe and feasible intervention for people with de Quervain's syndrome. A large multi-centre trial would be required to compare high- and low-load isometric exercises. Further research investigating exercise and multimodal interventions in this population is warranted. [ABSTRACT FROM AUTHOR]

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Objective: The prevention of thumb joints flexion help cure de Quervain tenosynovitis. The thumb, therefore, is being immobilized in the abduction position by splinting. Thumb abduction can be away from the palm (palmar abduction) or from the fingers (radial abduction), which are done in two different planes. To the authors' knowledge, the literature has not specified which kind of thumb abduction has better treatment outcomes and functions. This study aimed to compare the immediate efficacy of palmar abduction and radial abduction splinting on the severity of pain, handgrip, palmar and lateral pinch strength, and hand function in people with de Quervain tenosynovitis. Materials & Methods: In this quasi-experimental study, 30 volunteer patients (24 females) with de Quervain tenosynovitis referred to clinical centers were selected via convenience sampling. The participants were randomly assigned to three study groups (without the splint, palmar abduction splint, and radial abduction splint). The splints' height was two-thirds of the elbow. The splints were designed to immobilize the carpometacarpal and metacarpophalangeal joint of the thumb but allow the interphalangeal joint to move. One splint immobilizes the thumb in palmar abduction, while another immobilizes the thumb in radial abduction. The outcomes were studied and measured immediately after the intervention and in a single session. The intended outcomes included pain severity, handgrip strength, palmar and lateral pinch strength, and hand function measured with a visual analog scale, hand dynamometers, and the Jebsen-Taylor test, respectively. The repeated measures analysis of variance was performed for statistical analysis using SPSS software, version 16. Results: All participants completed all study assessments. The results showed a significant reduction of pain, handgrip strength, lateral and palmar pinch, and hand function after using a thumb splint compared to without the splint condition (P0.05). Conclusion: The positioning of the thumb in palmar abduction with splinting could be more effective for pain reduction and manipulation of objects with the hand and fingers.

Background & Method: The aim of present study is to describe typical sonographic appearance of lesion in wrist pain patient and detect pathology possible with wrist x ray. All patients with wrist joint pain examined by the orthopedic opd & ipd and referred to the dept. of radio-diagnosis. A pre-informed written consent is taken from the patient, which is attached to a questionnaire which include the patient's history, general physical examination and detailed wrist joint examination. Result: Cross sectional statistical analysis of X -ray findings of study subjects based on numbers and percentages, reveal that 91% of subjects had normal findings and rest 9% had abnormal findings. Cross sectional statistical analysis of ultrasound findings tendons of study subjects based on numbers and percentages, reveal that 27subjects had abnormal findings, among which 12 subjects had De Quervain's tenosynovitis, 7 subjects had flexor tenosynovitis, 8 subjects had extensor tenosynovitis. Conclusion: 100 Patients with wrist pain, associated symptoms include swelling 31 (31%), numbness 4 (4%), restriction of movements 3(3%). In 100 patients, 48 /100 (48%) had pain of more than 3 month duration. 100 patients with wrist pain, associated symptoms include swelling 31 (31%), numbness 4 (4%), restriction of movements 3(3%). In 100 patients, 48 /100 (48%) had pain of more than 3 month duration. The commonest pathology causing wrist pain is focal cystic masses which can be simple or infected followed by tendon pathologies like tenosynovitis commonly De Quervain's tenosynovitis. [ABSTRACT FROM AUTHOR]

The article focuses on the Carpal tunnel syndrome which is one of the most common problems presented to the hand surgeon. Topics include considered there has been a continued effort to refine the optimal diagnostic criteria for CTS and examines the Carpal Tunnel Syndrome-6 is a validated several-point scale that incorporates six aspects of the history and clinical examination to predict the probability of the presence of CTS.

OBJECTIVE: We aimed to show the effectiveness of different treatment methods in the prevention of clinical symptoms and recurrence of De Quervain Tenosynovitis (DQT), which is often seen in nursing women. PATIENTS AND METHODS: Three different treatment methods were used in 124 patients, all of whom were breastfeeding women who visited our clinic between 2017-2022 with a positive Finkelstein test and DQT. Group I comprised 56 patients who underwent surgical treatment under local anesthesia, Group II, 41 patients who received steroid injections as conservative treatment, and Group III, 27 patients who received wrist splints. The patient files of all groups were reviewed retrospectively, and the effects of the treatment methods on clinical symptoms and recurrence were investigated in patients who were followed up at the 2nd, 4th and 8th weeks. RESULTS: The recurrence rate of Group I patients, which were treated surgically, was significantly lower than that of Group II and III (p=0.0001). Among those who received conservative treatment, patients in Group II had significantly lower recurrence rates than those in Group III. At the 8th week of treatment, clinical symptoms had improved by 96.45%, 58.5%, and 7.4% in Groups I, II, and III, respectively. CONCLUSIONS: It is thought that the repetitive movements made during baby care and the edema that develops in breastfeeding women prepare the ground for DQT. Surgery is the most effective treatment method for the improvement of clinical symptoms and prevention of recurrence. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the outcomes of patients treated with a novel minimally invasive complete release of the first dorsal compartment percutaneously under ultrasound guidance using an 18-gauge needle with an 18 blade at the tip. Design: This was a retrospective case series. Nine adults (ten wrists) were included in the study of this technique. All patients had failed conservative care and had tenderness to palpation over the first dorsal compartment, a positive Finklestein test, and confirmed tenosynovitis with ultrasound imaging before the procedure. The main outcome measures were reduction in pain as determined by the numeric rating scale and improvement of function determined by the Nirschl Phase scale at both short- and long-term follow-up. Results: There was 100% follow-up, with mean (SD) follow-up occurring at 23.1 (9.8) mos (range, 9–42 mos). From preprocedure to follow-up, numeric rating scale pain decreased from 4.1 (SD, 2.5) to 0.0 (SD, 0.0) (P < 0.001), and Nirschl phase improved from 2.5 (SD, 1.9) to 0.2 (SD, 0.4) (P = 0.03). No patients required revision open-release surgery or suffered neurovascular complications. Conclusion: This technique resulted in significant improvement of pain and function for all patients and no short- or long-term neurovascular complications were seen. [ABSTRACT FROM AUTHOR]