Learn about De Quervain's Tenosynovitis, also known as Radial Styloid Tenosynovitis or de Quervains syndrome. This meta description focuses on healthcare aspects, clinical documentation, and medical coding for De Quervain's Disease. Find information relevant to diagnosis, treatment, and ICD-10 codes for medical professionals and patients seeking details on this condition.
Also known as
Synovitis and tenosynovitis
Inflammation of the synovial membrane (synovitis) and tendon sheaths (tenosynovitis).
Other soft tissue disorders
Encompasses various soft tissue disorders like bursitis, enthesopathies, and other specified soft tissue disorders.
Disorders of muscles and tendons
Includes conditions affecting muscles and tendons, such as tears, contractures, and other disorders.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diagnosis De Quervain's Tenosynovitis?
When to use each related code
| Description |
|---|
| Wrist pain at the base of the thumb, difficulty gripping. |
| Wrist pain radiating to forearm, often from repetitive movements. |
| Pain at intersection of thumb and wrist extensor tendons, often from repetitive hand use. |
Missing or incorrect laterality (right, left, bilateral) coding for De Quervain's Tenosynovitis impacts reimbursement and data accuracy.
Coding De Quervain's Disease without specifying tenosynovitis can lead to claim denials due to lack of specificity.
Insufficient documentation to support the diagnosis of De Quervain's Tenosynovitis may cause coding errors and compliance issues.
Q: What are the most effective differential diagnosis strategies for De Quervain's Tenosynovitis vs. Intersection Syndrome, and how can clinicians differentiate between these two conditions in physical examination?
A: Differentiating De Quervain's Tenosynovitis from Intersection Syndrome, though both involve wrist pain, requires a focused physical exam. De Quervain's involves the tendons of the abductor pollicis longus and extensor pollicis brevis at the radial styloid process, assessed with the Finkelstein's test. Intersection Syndrome, however, involves the intersection of these tendons with the abductor pollicis longus and extensor pollicis brevis tendons approximately 4-6 cm proximal to the radial styloid. Pain localized to this proximal intersection point and exacerbated by wrist flexion and ulnar deviation suggests Intersection Syndrome. Consider implementing palpation along the muscle bellies to pinpoint tenderness and crepitus. Explore how ultrasound imaging can further aid in differentiating these conditions and visualizing tendon sheath inflammation. Furthermore, patients with Intersection Syndrome may describe pain with activities like rowing or weightlifting, whereas De Quervain's is more commonly aggravated by repetitive thumb and wrist movements like pinching and grasping. Learn more about dynamic ultrasound and its role in diagnosing soft tissue disorders.
Q: Beyond corticosteroid injections, what non-surgical treatment options provide long-term relief for De Quervain's Tenosynovitis, especially for patients reluctant to undergo injections or surgery?
A: For patients seeking non-surgical and non-injection options for De Quervain's Tenosynovitis, a multi-pronged approach focusing on rest, immobilization, and targeted therapy can provide long-term relief. Initially, thumb spica splints or forearm-based thumb spica orthoses can immobilize the wrist and thumb, reducing tendon irritation. Explore how occupational therapy can help patients modify activities of daily living to avoid aggravating movements. Furthermore, consider implementing a progressive strengthening and stretching program guided by a hand therapist once pain subsides. Modalities like ultrasound therapy and iontophoresis can be adjunctive treatments to reduce pain and inflammation. Learn more about the efficacy of custom orthoses and the role of patient education in preventing recurrence.
Patient presents with complaints consistent with de Quervain's tenosynovitis, also known as radial styloid tenosynovitis or de Quervain's disease. The patient reports pain and tenderness along the radial side of the wrist, specifically at the base of the thumb. Symptoms include pain exacerbated by thumb and wrist movement, difficulty gripping, and occasional radiating pain up the forearm. On physical examination, positive Finkelstein's test was noted, eliciting sharp pain over the abductor pollicis longus and extensor pollicis brevis tendons. Differential diagnoses considered include intersection syndrome, wrist osteoarthritis, and scaphoid fracture. Assessment suggests de Quervain's tenosynovitis as the primary diagnosis. Initial treatment plan includes conservative management with rest, ice, NSAIDs for pain and inflammation, and thumb spica splint immobilization. Patient education provided regarding activity modification and proper splinting techniques. Follow-up scheduled in two weeks to assess response to treatment and consider corticosteroid injection if symptoms persist. ICD-10 code M65.44 (Tenosynovitis of wrist) is assigned. Referral to hand therapy or orthopedic specialist may be considered if conservative treatment fails.