In patients with dorsal tenosynovitis, the tenosynovium becomes hypertrophic (thickened and swollen). Dorsal tenosynovitis can cause pain as the extensor tendons move on the dorsum of the hand and wrist and collide with the dorsal wrist extensor retinaculum during combined wrist and finger extension. Persistent proliferative dorsal tenosynovitis can cause extensor tendon rupture.1 If the tenosynovitis affects only the first dorsal compartment, which includes the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB), it is called de Quervain’s disease. Symptoms of de Quervain’s include swelling at the radial styloid. However, de Quervain’s often occurs with hypertrophic tenisynovial changes.2
Pathophysiology
Initially, the underlying diagnosis causing the dorsal tenosynovitis is frequently unknown and can be difficult to establish. Rheumatoid arthritis (RA), tuberculosis, gout, mycobacterium marinum infections, sarcoidosis, or wrist osteoarthritis are diseases that can cause dorsal tenosynovitis. Patients presenting with RA often have involvement of the radiocarpal and distal radioulnar joints and the overlying extensor tendons.1
A few months of dorsal hand and wirsit swelling associated with intermittent pain, especially during extension of the fingers and wrist.