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Carpal tunnel syndrome — SCE Rheumatology MCQ

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HardOsteoarthritis and soft tissue rheumatologyCarpal tunnel syndromeSCE Rheumatology

A new mother has radial-sided wrist pain worsened by lifting her baby. There is focal tenderness over the first dorsal compartment and pain when the thumb is flexed into the palm with ulnar deviation. What is the diagnosis?

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Correct answer: E — De Quervain tenosynovitis

The best answer is “De Quervain tenosynovitis”. Radial styloid pain, first-dorsal-compartment tenderness and provocation by thumb flexion with ulnar deviation are typical of de Quervain tenosynovitis, often triggered by repetitive infant lifting. Carpal tunnel, ulnar neuropathy and radiculopathy cause neurological distributions, while tendon rupture causes loss of extension rather than this painful provocation pattern.

Reference: NHS wrist pain clinical information: https://www.nhs.uk/conditions/hand-pain/wrist-pain/