Skip to main content
SpringerLink
Log in

Diagnostic accuracy of imaging modalities in the detection of clinically diagnosed de Quervain’s syndrome: a systematic review

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objectives

To collate and synthesise the literature to provide estimates of the diagnostic accuracy of imaging modalities, and summarise the reported imaging findings associated with de Quervain’s syndrome.

Materials and methods

A systematic search was performed in seven databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PROSPERO, Web of Science, and ProQuest Dissertations & Theses Global). Two reviewers independently performed screening, data extraction and quality assessment using a modified Quality Assessment of Diagnostic Accuracy Studies-2. Measures of diagnostic accuracy were summarised for different modalities and imaging findings.

Results

Twenty-two studies were included, reporting ultrasound, magnetic resonance imaging, X-ray and scintigraphy findings. Reported imaging findings included sheath effusion, retinaculum thickening, subcutaneous oedema, tenosynovitis, hypervascularity, increased tendon size, bony erosion, apposition, calcific lesions and increased uptake on scintigraphy. The most commonly reported imaging findings related to the tendon sheath, with a sensitivity ranging from 0.45 to 1.00 for thickening, and 0.29 to 1.00 for effusions. The risk of bias of studies is largely unclear owing to a lack of reported detail.

Conclusions

The accuracy of imaging in the diagnosis of de Quervain’s syndrome is unable to be determined because of the quality of the studies included. Ultrasound is the most frequently studied imaging modality and may be the modality of choice in clinical practice. Further research involving both symptomatic and asymptomatic participants and clear definitions of abnormal findings are required to better evaluate the effectiveness of imaging in identifying de Quervain’s syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004;51(4):642–51.

    Article  Google Scholar 

  2. Leslie BM, Ericson WB Jr, Morehead JR. Incidence of a septum within the first dorsal compartment of the wrist. J Hand Surg. 1990;15(1):88–91.

    Article  CAS  Google Scholar 

  3. Lee ZH, Stranix JT, Anzai L, Sharma S. Surgical anatomy of the first extensor compartment: a systematic review and comparison of normal cadavers vs. De Quervain syndrome patients. J Plast Reconstr Aesthet Surg. 2017;70(1):127–31.

    Article  Google Scholar 

  4. 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(1):36–8.

    Article  Google Scholar 

  5. Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain’s tenosynovitis in a young, active population. J Hand Surg Am. 2009;34(1):112–5.

    Article  Google Scholar 

  6. Huisstede B, Coert J, Fridén J, Hoogvliet P. Consensus on a multidisciplinary treatment guideline for de Quervain disease: results from the European HANDGUIDE study. Phys Ther. 2014;94(8):1095.

    Article  Google Scholar 

  7. Stahl S, Vida D, Meisner C, Stahl AS, Schaller H-E, Held M. Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data. BMC Musculoskelet Disord. 2015;16(1):126.

    Article  Google Scholar 

  8. Clarke M, Lyall H, Grant J, Matthewson M. The histopathology of de Quervain’s disease. J Hand Surg. 1998;23(6):732–4.

    Article  CAS  Google Scholar 

  9. Read H, Hooper G, Davie R. Histological appearances in post-partum de Quervain’s disease. J Hand Surg Br. 2000;25(1):70–2.

    Article  CAS  Google Scholar 

  10. Kuo YL, Hsu CC, Kuo LC, Wu PT, Shao CJ, Wu KC, et al. Inflammation is present in de Quervain disease—correlation study between biochemical and histopathological evaluation. Ann Plast Surg. 2015;74:S146–51.

    Article  CAS  Google Scholar 

  11. Batteson R, Hammond A, Burke F, Sinha S. The de Quervain’s screening tool: validity and reliability of a measure to support clinical diagnosis and management. Musculoskeletal Care. 2008;6(3):168–80.

    Article  Google Scholar 

  12. Henderson RE, Walker BF, Young KJ. The accuracy of diagnostic ultrasound imaging for musculoskeletal soft tissue pathology of the extremities: a comprehensive review of the literature. Chiropr Man Therap. 2015;23(1):31.

    Article  Google Scholar 

  13. Dawson C, Mudgal CS. Staged description of the Finkelstein test. J Hand Surg. 2010;35(9):1513–5.

    Article  Google Scholar 

  14. Kutsumi K, Amadio PC, Zhao C, Zobitz ME, Tanaka T, An KN. Finkelstein’s test: a biomechanical analysis. J Hand Surg Am. 2005;30(1):130–5.

    Article  Google Scholar 

  15. Goubau JF, Goubau L, Van Tongel A, Van Hoonacker P, Kerckhove D, Berghs B. The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff’s test. J Hand Surg Eur Vol. 2014;39(3):286–92.

    Article  CAS  Google Scholar 

  16. Brunelli G. Finkelstein’s versus Brunelli’s test in De Quervain tenosynovitis. Chir Main. 2003;22(1):43–5.

    Article  CAS  Google Scholar 

  17. McInnes MD, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA. 2018;319(4):388–96.

    Article  Google Scholar 

  18. De Vet H, Eisinga A, Riphagen I, Aertgeerts B, Pewsner D. Chapter 7: searching for studies. Cochrane handbook for systematic reviews of diagnostic test accuracy: The Cochrane Collaboration; 2008.

  19. Bhargava SK, Thukral TA. De Quervain’s disease—sonographic evaluation. Ultrasound Int. 1997;3(4):222–6.

    Google Scholar 

  20. Choi SJ, Ahn JH, Lee YJ, Ryu DS, Lee JH, Jung SM, et al. de Quervain disease: US identification of anatomic variations in the first extensor compartment with an emphasis on subcompartmentalization. Radiology. 2011;260(2):480–6.

    Article  Google Scholar 

  21. Danda RS, Kamath J, Jayasheelan N, Kumar P. Role of guided ultrasound in the treatment of De Quervain tenosynovitis by local steroid infiltration. J Hand Microsurg. 2016;8(1):34–7.

    Article  Google Scholar 

  22. De Keating-Hart E, Touchais S, Kerjean Y, Ardouin L, Le Goff B. Presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in de Quervain’s syndrome. J Hand Surg Eur Vol. 2016;41(2):212–9.

    Article  Google Scholar 

  23. Giovagnorio F, Andreoli C, De Cicco ML. Ultrasonographic evaluation of de Quervain disease. J Ultrasound Med. 1997;16(10):685–9.

    Article  CAS  Google Scholar 

  24. Hadidy A, Hadidi S, Haroun A, Al-Hadidi M, Mahafza W, Badran D, et al. De Quervain’s tenosynovitis imaging: ultrasonography versus magnetic resonance imaging. J Bahrain Med Soc. 2009;21(4):328–33.

    Google Scholar 

  25. Hajder E, de Jonge MC, van der Horst CM, Obdeijn MC. The role of ultrasound-guided triamcinolone injection in the treatment of de Quervain’s disease: treatment and a diagnostic tool? Chir Main. 2013;32(6):403–7.

    Article  CAS  Google Scholar 

  26. Knobloch K, Gohritz A, Spies M, Vogt PM. Neovascularisation in de Quervain’s disease of the wrist: novel combined therapy using sclerosing therapy with polidocanol and eccentric training of the forearms and wrists—a pilot report. Knee Surg Sports Traumatol Arthrosc. 2008;16(8):803–5.

    Article  Google Scholar 

  27. Kwon BC, Choi SJ, Koh SH, Shin DJ, Baek GH. Sonographic identification of the intracompartmental septum in de Quervain’s disease. Clin Orthop Relat Res. 2010;468(8):2129–34.

    Article  Google Scholar 

  28. Lee KH, Kang CN, Lee BG, Jung WS, Kim DY, Lee CH. Ultrasonographic evaluation of the first extensor compartment of the wrist in de Quervain’s disease. J Orthop Sci. 2014;19(1):49–54.

    Article  CAS  Google Scholar 

  29. Marini M, Boni S, Pingi A, De Dominicis C, Cartolari R. De Quervain’s disease: diagnostic imaging. Chir Organi Mov. 1994;79(2):219–23.

    CAS  PubMed  Google Scholar 

  30. Nagaoka M, Matsuzaki H, Suzuki T. Ultrasonographic examination of de Quervain’s disease. J Orthop Sci. 2000;5(2):96–9.

    Article  CAS  Google Scholar 

  31. Volpe A, Pavoni M, Marchetta A, Caramaschi P, Biasi D, Zorzi C, et al. Ultrasound differentiation of two types of de Quervain’s disease: the role of retinaculum. Ann Rheum Dis. 2010;69(5):938–9.

    Article  CAS  Google Scholar 

  32. Anderson SE, Steinbach LS, De Monaco D, Bonel HM, Hurtienne Y, Voegelin E. Baby wrist: MRI of an overuse syndrome in mothers. AJR Am J Roentgenol. 2004;182(3):719–24.

    Article  Google Scholar 

  33. Glajchen N, Schweitzer M. MRI features in de Quervain’s tenosynovitis of the wrist. Skeletal Radiol. 1996;25(1):63–5.

    Article  CAS  Google Scholar 

  34. Chien AJ, Jacobson JA, Martel W, Kabeto MU, Marcantonio DR. Focal radial styloid abnormality as a manifestation of de Quervain tenosynovitis. AJR Am J Roentgenol. 2001;177(6):1383–6.

    Article  CAS  Google Scholar 

  35. Hanlon CR. DeQuervain’s disease. Am J Surg. 1949;77(4):491–8.

    Article  CAS  Google Scholar 

  36. Nyska M, Floman Y, Fast A. Osseous involvement in de Quervain’s disease. Clin Orthop Relat Res. 1984;(186):159–61.

  37. Suresh SS, Zaki H, Ali A. Does radial styloid abnormality in de Quervain’s disease affect the outcome of management? Hand. 2010;5(4):374–7.

    Article  CAS  Google Scholar 

  38. Weston WJ. De Quervain’s disease—stenosing fibrous tendovaginitis at the radial styloid process. Br J Radiol. 1967;40(474):446–8.

    Article  CAS  Google Scholar 

  39. Leslie WD. The scintigraphic appearance of de Quervain tenosynovitis. Clin Nucl Med. 2006;31(10):602–4.

    Article  Google Scholar 

  40. Bossuyt P, Davenport C, Deeks J, Hyde C, Leeflang M, Scholten R. Cochrane handbook for systematic reviews of diagnostic test accuracy. The Cochrane Collaboration; 2008.

  41. Kim H-R, Lee S-H. Ultrasonographic assessment of clinically diagnosed trigger fingers. Rheumatol Int. 2010;30(11):1455–8.

    Article  Google Scholar 

  42. Sato J, Ishii Y, Noguchi H. Ultrasonographic evaluation of the prevalence of an intracompartmental septum in patients with de Quervain’s disease. Orthopedics. 2016;39(2):112–6.

    Article  Google Scholar 

  43. Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making. 1991;11(2):88–94.

    Article  CAS  Google Scholar 

  44. Kumar Y, Alian A, Ahlawat S, Wukich DK, Chhabra A. Peroneal tendon pathology: pre- and post-operative high resolution US and MR imaging. Eur J Radiol. 2017;92:132–44.

    Article  Google Scholar 

Download references

Acknowledgements

This research has been supported by an Australian Government Research Training Program Scholarship, awarded to Brodwen McBain. Ebonie Rio is supported by the National Health and Medical Research Council Early Career Fellowship Scheme.

One author, Brodwen McBain, has received funding from the Australian Government in the form of an Australian Government Research Training Program Scholarship.

Author information

Authors and Affiliations

  1. La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering, La Trobe University, Bundoora, Australia

    Brodwen McBain, Ebonie Rio, Jill Cook & Sean Docking

  2. Victoria House Medical Imaging, I-MED Radiology Network, Melbourne, Australia

    Rafal Grabinski

Authors
  1. Brodwen McBain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ebonie Rio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jill Cook
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rafal Grabinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sean Docking
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brodwen McBain.

Ethics declarations

Conflicts of interest

Author, Rafal Grabinski, is a practicing radiologist, and as such receives remuneration for the delivery of radiology consultancy services. Each author certified that he or she has no other commercial association that might pose a conflict of interest in connection with the submitted article.

Ethical review committee statement

As this article is a systematic review of previously published articles, ethical approval was not required.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This work was performed at La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia

Electronic supplementary material

ESM 1

(PDF 179 kb)

ESM 2

(PDF 149 kb)

ESM 3

(PDF 92.0 kb)

ESM 4

(PDF 754 kb)

ESM 5

(PDF 85.8 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McBain, B., Rio, E., Cook, J. et al. Diagnostic accuracy of imaging modalities in the detection of clinically diagnosed de Quervain’s syndrome: a systematic review. Skeletal Radiol 48, 1715–1721 (2019). https://doi.org/10.1007/s00256-019-03195-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-019-03195-z

Keywords

Search

Navigation