De Quervians - Clinical Scenario

A 36-year-old right-handed woman presents with a 3-month history of progressively worsening radial wrist pain, primarily on her dominant side. She describes the pain as sharp and localized around the base of the thumb, and she has significant difficulty performing activities such as lifting her baby and opening jars. She recently gave birth and is currently breastfeeding. There is no history of trauma to the wrist, but she reports repetitive lifting and gripping associated with childcare.

Objectives:

1. Perform a comprehensive history focused on identifying risk factors and potential triggers for De Quervain's tenosynovitis.
2. Conduct a targeted physical examination and determine appropriate investigations to confirm the diagnosis and rule out differential conditions.
3. Develop a personalized treatment plan, considering both conservative and surgical options, tailored to the patient's postpartum status and functional needs.
4. Counsel the patient on the risks, benefits, and expected outcomes of various treatment approaches, including corticosteroid injections and surgical intervention if necessary.
   
   Primary Contributor: Dr Waruguru Wanjau, Educational Fellow.
   Reviewer: Dr Suzanne Thomson, Educational Fellow.