Repetitive movements of the thumb and wrist, as well as. It can develop after a thumb injury, repetitive movements, rheumatoid arthritis and other. Thickening and increased signal of the epb and apl tendons. Once your symptoms are better, work to prevent the condition from happening again. It is a stenosing tenosynovitis of the abductor pollicis longus apl and extensor pollicis brevis epb tendons fig. Pain may appear gradually or suddenly and can travel up the forearm. The provocative finkelstein test, in which the thumb is flexed and held inside a fist, and patient actively clearly deviates the wrist, causes sharp pain along the radial wrist at the first dorsal compartment. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. During the procedure, the patient will generally lie down on the back with the arm out to the side. If you start treatment early, your symptoms should improve within four to six weeks. The lunate derives its name from its similarity in shape to the moon. These tendons are responsible for helping to extend the thumb, and they glide through a protective covering called a tendon sheath. It commonly manifests in parents of newborns because of repetitive lifting with wrists in radial deviation. This compartment contains the abductor pollicis longus apl and extensor pollicis brevis epb tendons.
You may have pain when you move your wrist or pick things up. The result is pain at the base of the thumb and extending into the lower arm. A 34yearold right handdominant female who works in a daycare facility presents with. It is the middle carpal bone of the proximal carpal row and plays an integral part in carpal kinematics. Two or sometmes three tendons run through this canal to the thumb. Small effusion in the 1st extensor compartment sheath. The extensor pollicis brevis and the abductor pollicis longus muscles are responsible for lifting the thumb up and away from the palm. It develops when the abductor pollicis longus apl and extensor pollicis brevis epb tendons around the base of the thumb become swollen, often causing inflammation to develop. It used to be referred to as washerwomans sprain or mothers wrist but with the advent of technology, is now commonly referred to as blackberry thumb from typing and texting on small handheld devices. Place your hand on a flat surface, with your palm up. The swollen tendons and their coverings rub against the narrow tunnel through which they pass. Directly before the wrist imagine an extension from the thumb to the forearm exist a tunnel.