Case history
Case history #1
A 55-year-old woman with diabetes mellitus reports pain and catching of her left dominant thumb. She works as a secretary. The symptoms started over the past several months; no other digits are involved. She denies any locking of her thumb, and can actively flex and extend her thumb, although sometimes with difficulty. On exam, a tender palpable nodule could be felt over her left thumb metacarpophalangeal joint. When asked to flex and extend her thumb, she could easily flex, but her thumb clicks on the way to full extension.
Case history #2
A 60-year-old man presents with right wrist pain. He works as a laborer. The pain is located over the dorsal radial side of his wrist. It is exacerbated while at work and improves with rest. He has no limitation of motion, but ulnar deviation is very painful. He has local tenderness in the area of the radial styloid.
Other presentations
Stenosing tendinopathy can involve any extrinsic tendon of the hand or wrist. It usually presents with pain and swelling in the area where the tendon passes through its retinacular sheath. Early on the tendon shows full active motion. Later the tendon progresses into catching and ultimately locking, such as in trigger finger.
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