Sonographic Identification of the Intracompartmental Septum in de Quervain’s Disease
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The intracompartmental septum in the first extensor compartment in patients with de Quervain’s disease has been associated with disease development and prognosis. However, with the exception of surgical exploration, there is no way of detecting the septum.
We evaluated the accuracy of sonography for identifying the intracompartmental septum in the first extensor compartment in patients with de Quervain’s disease using surgical findings as the reference standard.
Patients and Methods
We performed surgical release of the first extensor compartment in 43 wrists of 40 patients who were unresponsive to nonoperative treatment. In each case, a sonographic evaluation was performed before surgery by a radiologist and the sonographic and surgical findings were compared.
Sonography identified the intracompartmental septum in 19 of the 19 septum-present wrists and absence of the septum in 23 of the 24 septum-absent wrists. The sensitivity of sonography was 100% (95% confidence interval, 80%–100%), its specificity 96% (95% confidence interval, 78%–100%), accuracy 98% (95% confidence interval, 87%–100%), positive predictive value 95% (95% confidence interval, 74%–100%), and negative predictive value 100% (95% confidence interval, 83%–100%). Sonography also identified septum-like structures in 15 of 37 (41%) asymptomatic contralateral wrists.
Sonography is useful for detecting the intracompartmental septum in the first extensor compartment in patients with de Quervain’s disease.
Level of Evidence
Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
- Agresti A, Coull BA. Approximate is better than “exact” for interval estimation of binominal proportions. Am Statist. 1998;52:119–126. CrossRef
- Avci S, Yilmaz C, Sayli U. Comparison of nonsurgical treatment measures for de Quervain’s disease of pregnancy and lactation. J Hand Surg Am. 2002;27:322–324. CrossRef
- Bahm J, Szabo Z, Foucher G. The anatomy of de Quervain’s disease: a study of operative findings. Int Orthop. 1995;19:209–211. CrossRef
- Giles KW. Anatomical variations affecting the surgery of de Quervain’s disease. J Bone Joint Surg Br. 1960;42:352–355.
- Harvey FJ, Harvey PM, Horsley MW. De Quervain’s disease: surgical or nonsurgical treatment. J Hand Surg Am. 1990;15:83–87. CrossRef
- Jackson WT, Viegas SF, Coon TM, Stimpson KD, Frogameni AD, Simpson JM. Anatomical variations in the first extensor compartment of the wrist: a clinical and anatomical study. J Bone Joint Surg Am. 1986;68:923–926.
- Jayaraman S, Naidich TP. The carpal tunnel: ultrasound display of normal imaging anatomy and pathology. Neuroimaging Clin N Am. 2004;14:103–113, viii.
- Keon-Cohen B. De Quervain’s disease. J Bone Joint Surg Br. 1951;33:96-99.
- Kulthanan T, Chareonwat B. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study. Scand J Plast Reconstr Surg Hand Surg. 2007;41:36–38. CrossRef
- Leao L. De Quervain’s disease: a clinical and anatomical study. J Bone Joint Surg Am. 1958;40:1063–1070.
- Leslie BM, Ericson WB Jr, Morehead JR. Incidence of a septum within the first dorsal compartment of the wrist. J Hand Surg Am. 1990;15:88–91. CrossRef
- Louis DS. Incomplete release of the first dorsal compartment: a diagnostic test. J Hand Surg Am. 1987;12:87–88.
- Minamikawa Y, Peimer CA, Cox WL, Sherwin FS. De Quervain’s syndrome: surgical and anatomical studies of the fibroosseous canal. Orthopedics. 1991;14:545–549.
- Nagaoka M, Matsuzaki H, Suzuki T. Ultrasonographic examination of de Quervain’s disease. J Orthop Sci. 2000;5:96–99. CrossRef
- Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006;55:765–778. CrossRef
- Rossi C, Cellocco P, Margaritondo E, Bizzarri F, Costanzo G. De Quervain disease in volleyball players. Am J Sports Med. 2005;33:424–427. CrossRef
- Ta KT, Eidelman D, Thomson JG. Patient satisfaction and outcomes of surgery for de Quervain’s tenosynovitis. J Hand Surg Am. 1999;24:1071–1077. CrossRef
- Weiss AP, Akelman E, Tabatabai M. Treatment of de Quervain’s disease. J Hand Surg Am. 1994;19:595–598. CrossRef
- Witt J, Pess G, Gelberman RH. Treatment of de Quervain tenosynovitis: a prospective study of the results of injection of steroids and immobilization in a splint. J Bone Joint Surg Am. 1991;73:219–222.
- Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain’s tenosynovitis in a young, active population. J Hand Surg Am. 2009;34:112–115. CrossRef
- Yuasa K, Kiyoshige Y. Limited surgical treatment of de Quervain’s disease: decompression of only the extensor pollicis brevis subcompartment. J Hand Surg Am. 1998;23:840–843. CrossRef
- Zingas C, Failla JM, Van Holsbeeck M. Injection accuracy and clinical relief of de Quervain’s tendinitis. J Hand Surg Am. 1998;23:89–96. CrossRef
- Sonographic Identification of the Intracompartmental Septum in de Quervain’s Disease
Clinical Orthopaedics and Related Research®
Volume 468, Issue 8 , pp 2129-2134
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- 1. Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Pyeongchon-dong Dongan-gu, Anyang-si Gyeonggi-do, 431-070, South Korea
- 2. Department of Radiology, Hallym University Sacred Heart Hospital, Kyeonggido, South Korea
- 3. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea