De Quervain tenosynovitis — SCE Rheumatology MCQ

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EasyOsteoarthritis and soft tissue rheumatologyDe Quervain tenosynovitisSCE Rheumatology

A 33-year-old man has radial wrist pain after repetitive lifting. Examination shows tenderness is maximal over the first dorsal compartment. Investigations show Finkelstein test is positive. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: D — De Quervain tenosynovitis

De Quervain tenosynovitis is the best answer because the pattern described is most consistent with De Quervain tenosynovitis, including the distribution of symptoms and the targeted investigation results. Psoriatic arthritis is a plausible distractor, but it does not account for the key discriminator in the stem. Gout and Primary Sjögren syndrome would be more appropriate in a different clinical pattern or at another point in the pathway, while ANCA-associated vasculitis is suboptimal for this presentation. Clinical pearl: in SCE-style questions, the decisive clue is usually the pattern across joints, extra-articular features and targeted immunology rather than a single antibody result.

Reference: NICE NG226; NICE CKS musculoskeletal topics