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De Quervain tenosynovitis — SCE Rheumatology MCQ

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EasyOsteoarthritis and soft tissue rheumatologyDe Quervain tenosynovitisSCE Rheumatology

A 37-year-old new mother has radial-sided wrist pain when lifting her baby. Pain is reproduced by thumb flexion into the palm with ulnar deviation of the wrist, and there is tenderness over the first dorsal extensor compartment. What is the most likely diagnosis?

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Correct answer: B — De Quervain tenosynovitis

Postpartum radial wrist pain with a positive Finkelstein-type manoeuvre indicates De Quervain tenosynovitis. Carpal tunnel syndrome causes median nerve paraesthesia rather than first compartment pain. Thumb CMC OA is less likely in this age group and would centre on the basal joint.

Reference: BSR rheumatology curriculum; NICE MSK guidance