William D Leslie1. 1. Department of Nuclear Medicine, St Boniface Hospital, Winnipeg, Manitoba, Canada. bleslie@sbgh.mb.ca
Abstract
PURPOSE: The purpose of this study is to describe the scintigraphic pattern of de Quervain tenosynovitis, a common inflammatory condition of the thumb tendon sheaths related to repetitive use. MATERIALS AND METHODS: The author conducted a retrospective audit of consecutive cases with independent clinical validation of the final diagnosis. RESULTS: There were 7 cases of clinically confirmed de Quervain tenosynovitis. The typical scintigraphic finding was a focal area of superficial linear hyperemia and skeletal uptake along the radial aspect of the distal radius corresponding to the anatomic location of the abductor pollicis longus and extensor pollicis brevis. All cases showed an abnormality on at least one phase of the bone scan. CONCLUSIONS: Bone scanning appears to be of value in the differential diagnosis of dorsolateral wrist pain when clinical findings are nondiagnostic. The scintigraphic appearance of de Quervain tenosynovitis can help to confirm the diagnosis while excluding other causes of wrist pain. Determining the sensitivity and specificity of this pattern will require further research.
PURPOSE: The purpose of this study is to describe the scintigraphic pattern of de Quervain tenosynovitis, a common inflammatory condition of the thumb tendon sheaths related to repetitive use. MATERIALS AND METHODS: The author conducted a retrospective audit of consecutive cases with independent clinical validation of the final diagnosis. RESULTS: There were 7 cases of clinically confirmed de Quervain tenosynovitis. The typical scintigraphic finding was a focal area of superficial linear hyperemia and skeletal uptake along the radial aspect of the distal radius corresponding to the anatomic location of the abductor pollicis longus and extensor pollicis brevis. All cases showed an abnormality on at least one phase of the bone scan. CONCLUSIONS: Bone scanning appears to be of value in the differential diagnosis of dorsolateral wrist pain when clinical findings are nondiagnostic. The scintigraphic appearance of de Quervain tenosynovitis can help to confirm the diagnosis while excluding other causes of wrist pain. Determining the sensitivity and specificity of this pattern will require further research.