Ultrasonographic Evaluation and Treatment for Dequervain’s Disease

Abstract

We performed ultrasonography in patients with de Quervain’s disease to examine the presence or absence of a septum and the extent of hypoechoic areas around tendons. We also compared the ultrasonographic findings with therapeutic outcomes. The subjects were 151 hands (96 conservatively-treated hands, 55 surgically-treated hands) of 146 patients who underwent ultrasonography at the time of initial examination or during treatment. We evaluated the presence or absence of a septum mainly on short axial images and the degree of tendon sheath thickening based on hypoechoic areas around the extensor pollicis brevis and abductor pollicis longus tendons. Among those with a septum and hypoechoic areas around these tendons, more hands were treated surgically, more injections were given, and the time-to-remission tended to be longer. Among those without a septum but with hypoechoic areas, there were more hands responding to conservative therapy. Among those with neither a septum nor a hypoechoic area, there were no surgically treated cases, and remission was obtained in the early stage. According to ultrasonographic findings indicating the presence or absence of a septum and hypoechoic areas, the subjects were classified into 4 types, and these types reflected the therapeutic effects.