To perform the test, the examiner grasps and ulnar deviates the hand when the person has their thumb held within their fist. If sharp pain occurs along the distal radius (top of forearm, about an inch below the wrist), de Quervains syndrome is likely. While a positive Finkelsteins test is often considered pathognomonic for de Quervain syndrome, the maneuver can also cause pain in those with osteoarthritis at the base of the thumb. Differential diagnosis
Differential diagnoses include:

Osteoarthritis of the trapezio-metacarpal joint
Intersection syndrome—pain will be more towards the middle of the back of the forearm and about 2–3 inches below the wrist, usually with associated crepitus. Wartenbergs syndrome: The primary symptom is paresthesia (numbness/tingling). Treatment
As with many musculoskeletal conditions, the management of de Quervains disease is determined more by convention than scientific data. A systematic review and meta-analysis published in 2013 found that corticosteroid injection seems to be an effective form of conservative management of de Quervains syndrome in approximately 50% of patients, although more research is needed regarding the extent of any clinical benefits. Efficacy data are relatively sparse and it is not clear whether benefits affect the overall natural history of the illness. One of the most common causes of corticosteroid injection failure are subcompartments of the extensor pollicis brevis tendon.Most tendinoses are self-limiting and the same is likely to be true of de Quervains although further study is needed.Palliative treatments include a splint that immobilized the wrist and the thumb to the interphalangeal joint and anti-inflammatory medication or acetaminophen.
Causes for the condition extend beyond smartphones and gaming consoles to include activities like golf, racket sports, and lifting.Symptoms of BlackBerry thumb include aching and throbbing pain in the thumb and wrist. In severe cases, it can lead to temporary disability of the affected hand, particularly the ability to grip objects.One hypothesis is that the thumb does not have the dexterity the other four fingers have and is therefore not well-suited to high speed touch typing. See also
Mobile phone overuse
Nomophobia

References


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