Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a [duration] history of radial-sided wrist pain, exacerbated by thumb abduction and wrist ulnar deviation. Pain is described as [sharp/aching], localized to the first dorsal compartment. Patient reports difficulty with activities involving repetitive thumb use, pinching, or grasping. No history of acute trauma.
Clinical Examination Findings
Inspection: Mild swelling noted over the radial styloid. Palpation: Significant tenderness to palpation over the first dorsal compartment. Range of Motion: Pain with active and passive thumb abduction and wrist ulnar deviation. Special Tests: Finkelstein test is positive, eliciting sharp pain along the APL and EPB tendons. Neurovascular: Distal sensation intact; radial pulse 2+; capillary refill <2 seconds.
Treatment Protocol
Conservative management initiated: 1) Activity modification and avoidance of repetitive thumb/wrist motions. 2) Thumb spica splinting for immobilization. 3) NSAIDs as directed for inflammation. 4) Consider corticosteroid injection into the first dorsal compartment if symptoms persist. 5) Referral to hand therapy for ergonomic assessment and tendon gliding exercises.