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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report 62 cases of De Quervain tenosynovitis treated from 1983 to 1990 by the same surgeon. The de Quervain's tenosynovitis is an inadequation between the volume of the abductor pollicis longus and the extensor pollicis brevis and their tunnel above the radial styloid process producing a mechanical tenosynovitis. This disease occurs mostly in women with an average age of 47 and almost never before the age of 30. Clinically the patients have pain and swelling above the radial styloid process. Most of the surgeons know today this disease, nevertheless complications may occur (Abductor pollicis longus luxation, disgratious enlargement and adhesion of the scar). The transversal incision provides a less disgracious scar. As the tendinous pulley is opened frequent anatomical variations of the tendons are found. A ventral capsular flap fixation with a subcuticular continuous suture is made. This fixation prevents any ventral luxation. Radial nerve neuromas or neuritis is constantly looked for. The authors expose and analyse the statistical data of this intervention's results with a 6 month minimal and 7 years maximal follow up.
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PMID:[De Quervain's tenosynovitis. Transversal scar and fixation of the capsular flap]. 141 Jul 15

Ninety-one wrists in 82 consecutive patients with Quervain's disease were treated by the one surgeon between 1978 and 1987. The treatment of 79 wrists in 71 patients who had received their entire treatment from this surgeon is analyzed. Uniformity of injection technique is thus ensured. Initial treatment in 63 wrists was an injection of steroids and local anesthetic into the tendon sheath, which gave complete relief in 45 cases. Seven wrists received two injections before the pain abated. Only 11 of the 63 injected wrists had an operation. In 10 of these the extensor pollicis brevis tendon was in a separate compartment. It is concluded that injection of steroids is the preferred initial treatment in de Quervain's disease, giving complete and lasting relief in 80% of cases. If injection fails, it appears likely that the extensor pollicis brevis tendon lies in a separate compartment.
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PMID:De Quervain's disease: surgical or nonsurgical treatment. 229 73

De Quervain disease (1895), tenosynovitis of Abductor Pollicis Longus and Extensor Pollicis Brevis, passing through their tunnel above the Radial Styloid Process, is not always cured by medical treatment but often requires surgical treatment. So, it is necessary to use a surgical one. The classical procedure, simple section of the radio-styloid pulley, is often complicated by the shifting of the two tendons on the radial styloid process caused by the wrist movements. Recently, an Italian author, G. Codega proposed an enlarging-reconstructing technique. The one described in this article consists of enlargement of the pulley by means of a diagonal incision, followed by suture after shifting of the diagonals. This technique ensures a real enlargement and solid reconstruction which allows early rehabilitation. The pain disappears at the same time as post-operative pain. Because of the small number of patients operated to data, it is not yet possible to perform statistical analysis, but the results have always been good or excellent.
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PMID:[Enlargement plasty of the radio-styloid tunnel in the treatment of De Quervain tenosynovitis]. 234 50

After removal of the trapezium, imbrication of abductor pollicis longus and fixing it with a strip of flexor carpi radialis tendon, we obtained a stable arthroplasty having three quarters of normal mobility and half to full power. Of the first 100 operated thumbs, 15 patients had slight pain on heavy use; the rest were painfree. Three patients had radial nerve lesions with minor complaints. Seven patients developed de Quervain's syndrome and two had rupture of abductor pollicis longus; these complications have since been avoided by routinely splitting the first extensor compartment. Four cases with unstable joints required further surgery, and one joint became stiff due to extra-articular conditions.
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PMID:Tendon interposition arthroplasty of the first carpo-metacarpal joint. 324 43

The records of eight patients with thyroid tenderness secondary to Hashimoto's thyroiditis were reviewed. The pathologic characteristics of thyroid tissue sections from these patients were compared with those from patients with nontender Hashimoto's thyroiditis, and no difference was identified. Laboratory features helpful in distinguishing tender Hashimoto's thyroiditis from subacute (de Quervain's) thyroiditis include normal erythrocyte sedimentation rate, significant 131I uptake, and significant antithyroid antibody titer. Diagnosis should be confirmed by fine-needle aspiration biopsy. Corticosteroid therapy was unsuccessful in treating these patients; L-thyroxine and aspirin were successful more often. Two patients required thyroidectomy to control pain.
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PMID:Hashimoto's thyroiditis. An uncommon cause of painful thyroid unresponsive to corticosteroid therapy. 375 33

This study presents a retrospective analysis of clinical and laboratory results of 22 patients--predominantly younger women--with thyroiditis de Quervain. Diagnosis is based on clear leading symptoms like swelling and tenderness of the thyroid on pressure, swallowing with pain radiating to mandible and/or ears, fever and increased erythrocyte sedimentation rate (ESR). Half of the patients had slight anemia, leucocytosis without shift to the left, lymphopenia and thrombocytosis. The therapy of choice was prednisone, starting with an initial dose of usually 50 mg, reduced stepwise over 3 months under control of the clinical picture and the sedimentation rate. In a third of the patients clinical symptoms of the disease that had disappeared transiently redeveloped under reduction of prednisone without increase of the erythrocyte sedimentation rate. Raising the dose of prednisone for a short while led to prompt disappearance of symptoms. The ESR thus supports diagnostic investigations; however, it fails as a control parameter for the course of disease under treatment.
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PMID:[Steroid therapy and course of blood sedimentation rate in de Quervain's thyroiditis]. 811 64

The most common form of thyroiditis is undoubtedly chronic lymphocytic thyroiditis (Hashimoto's thyroiditis). It presents in the form of a small insignificant struma without any signs of inflammation, which is easily overlooked in our region (where once goiters due to iodine-deficiency have been common). Therapy is only indicated when the patient is disturbed by the size of the goiter or when he is hypothyroid. The disease can be easily diagnosed by palpation and investigation of autoantibodies. Repeated antibody-tests are not necessary, however, it is useful to measure TSH every two years since some of the patients develop hypothyroidism. In contrast to the relatively mild findings in Hashimoto's thyroiditis the subacute granulomatous thyroiditis (de Quervain) presents with an impressive clinical picture with pain, fever, malaise and elevated blood sedimentation rate, that may alarm the patient as well as the unexperienced physician. Treatment with prednisone is extremely effective and leads to complete remission.
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PMID:[Thyroiditis]. 829 30

De Quervain disease is a job-related tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis muscles; it is associated with pain and functional impairment and progresses to cause local fibrosis with blockage or triggering of the thumb. High-resolution ultrasonography of the wrist was performed in eight patients with de Quervain disease; the examination was performed in axial and coronal scans with a 13 MHz linear transducer. The evaluation of normal wrists helped to define the normal sonographic anatomy of the first extensor compartment; obvious changes of the tendon sheath were noted in all cases of de Quervain disease (thickening and edema of the synovial sheath and fluid within the sheath). We conclude that ultrasonography is able to confirm the clinical diagnosis of de Quervain disease and may have a role in the follow-up of this disorder.
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PMID:Ultrasonographic evaluation of de Quervain disease. 932 74

We describe a 39-year-old woman presenting with a painless solitary thyroid nodule, initially without signs suggesting thyroiditis. The serum level of thyrotropin was suppressed whereas those of thyroxine and triiodothyronine were normal. Fine needle aspiration cytology showed no signs of inflammation or malignancy. One week later, the patient felt pain and tenderness on her neck, and erythrocyte sedimentation rate and C-reactive protein were markedly elevated. Thyroid scintigraphy showed a suppressed thyroid pertechnetate uptake. At that time, the diagnosis of subacute thyroiditis was made. Upon treatment with steroids the patient's symptoms as well as the thyroid nodule resolved. This case illustrates that subacute thyroiditis de Quervain may present as a solitary, painless nodule with suppressed thyrotropin and should therefore be considered in the differential diagnosis of such lesions.
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PMID:De Quervain's subacute thyroiditis presenting as a painless solitary thyroid nodule. 1021 54

Extensor triggering is an uncommon but recognized component of de Quervain's stenosing tenosynovitis. In a retrospective review of 827 patients with the diagnosis of de Quervain's disease over a 5-year period, 11 patients with 13 affected wrists were identified who had demonstrable triggering by both history and physical examination (prevalence of 1.3%). One wrist underwent surgical release without conservative treatment. The remaining 12 wrists were initially treated with nonoperative modalities. Failure of conservative treatment as defined by recurrent triggering and pain occurred in 7 wrists, of which 5 underwent surgical release. At the time of surgery, all wrists were noted to have synovitis, separate compartments for the extensor pollicis brevis and abductor pollicis longus tendons, and no intratendinous nodules. After an average follow-up period of 42 months (range, 5.7-94.5 months) there were no recurrences of triggering after surgical treatment. Seven of 12 wrists with triggering de Quervain's stenosing tenosynovitis failed nonoperative treatment. Triggering or locking in extension is an uncommon symptom in de Quervain's stenosing tenosynovitis and demonstrates a more recalcitrant course when treated nonoperatively.
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PMID:Extensor triggering in de Quervain's stenosing tenosynovitis. 1058 59


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