De Carven's disease: symptoms, diagnosis, treatment

De Carven's disease is a pathology characterized by inflammation of the tendons on the thumb. The disease manifests itself gradually, differs by a rather slow development. Sometimes before going to the doctor it takes several weeks or even months.

Description of the disease

De Carven's disease (chronic tenosynovitis or stenosing ligamentitis) is a pathology that is characterized by a gradual narrowing of the canal where the tendons of the thumb pass. The disease is accompanied by inflammation of the so-called tendinous vaginas. The disease occurs due to the constant stress on the brush, often in connection with the performance of professional activities. Because of pain in patients, the ability to perform certain movements with the participation of absolutely the entire brush is reduced.

Periodic contraction of the muscles of the forearm makes it possible to bend / unbend fingers. For these movements, tendons of the flexor muscles (approach the fingers via the palmar surface) and the extensor muscles (pass through the back of the hand) are responsible. The transverse ligaments ensure the retention of the tendons in the required position. The back ligament is localized on the same side of the hand. Each group of tendons in the latter is in a separate channel. The thumb is actively involved in the daily life of a person. His tendons take on the greatest strain. The disease of de Kerven provokes a consistent inflammation of the ligaments, their thickening and swelling. As a result, the channel becomes excessively small, symptoms of an ailment occur, and the whole brush function is disrupted.

What causes the development of pathology?

The exact causes of the appearance of this disease remain unexplored until the end. It is assumed that the constant repetitive activity of brushes (playing golf, gardening, caring for a child) can exacerbate this condition. Therefore, sometimes the disease is called "mother's wrist."

Also, experts identify a number of factors that contribute to the development of pathology, namely:

• Injuries and mechanical damage to the brush.
• Diseases of the joints of inflammatory nature (arthritis, arthrosis).
• Constant load on the area of the wrist joint.
• Hormonal reorganization of the body (often in the menopause period).
• Anatomical features of the musculoskeletal system.

Who is at risk?

The highest risk of this pathology in people aged 30 and up to about 50 years. De Quervain's disease is more often diagnosed in the fair sex during pregnancy and care for the newborn.

What signs are accompanied by pathology?

The main symptom of this ailment is pain in the zone of wrist joint from the side of the thumb. When you turn the brush, discomfort can increase. The pain often gives in the forearm and neck area.

A distinctive sign of the disease is a symptom of Finkelstein. The man, clasping his hand into a fist, puts his thumb inside. If the next attempt to take your hand to the side is accompanied by a sharp pain, you can confirm de Kerven (disease).

When palpation of the joint, there is a slight swelling, tenderness from the affected side.

The main mistake of many patients is not recourse to qualified help, but ordinary immobilization of the brush. For these purposes tight bandages, special wristbands are used. In this case, the onset of an illness is the cause of disability. Patients can not perform even the most usual household chores (peeling potatoes, washing, unbuttoning buttons, etc.).

Establishing diagnosis

De Cervin's disease should not be ignored. Symptoms of the pathology, manifested for several days in a row, should alert and become an excuse for an immediate call to a doctor.

At the consultation, the specialist performs a physical examination of the affected area, can ask a number of clarifying questions (when there are pains, their possible causes). To confirm the diagnosis, the doctor conducts several tests.

• Strained abduction. The specialist pushes the thumb down from the back so as to bring it to the palm of your hand. On an absolutely healthy hand, the finger should resist pressure. In the case of pathology, soreness appears when touched.
• Ability to hold objects. The patient should take each hand in the subject. If you pull it lightly, a healthy arm will hold the object with more force, which can not be said about the patient.
• X-ray examination can also confirm de Quervain's disease. Photo (snapshot) of the hands allows to reveal the presence of thickening of the soft tissues, changes in the periosteum.

Conservative therapy

First of all, patients are recommended to stop the previously performed activities with mandatory immobilization of the affected area. The immobilization of the hand must be carried out in such a way that the thumb is permanently bent in relation to the index and middle finger. For these purposes, the best solution is to use a cast bandage, which is applied to the middle of the forearm. Such immobilization only prevents the joint from possible traumatization. In addition, appropriate conservative therapy should be conducted.

Inflammatory changes in ligaments form the basis of a pathology such as de Cervin's disease. Treatment involves the application of physiotherapeutic procedures (paraffin, ultrasound with hydrocortisone). In addition, anti-inflammatory drugs ("Ibuprofen", "Naproxen"), steroid injections ("Hydrocortisone") are prescribed.

When is surgery required?

Surgical intervention is recommended when conservative therapy is ineffective or there is a two-way lesion.

The operation is performed under stationary conditions using a local anesthetic version. Before the beginning of direct anesthesia, the doctor marks the most painful area with a special marker. Then novocaine is introduced, and a cross-section is made over the zone of the so-called styloid process, which passes through this point. A dull crochet gently devotes subcutaneous tissue along with the veins, exposing the back ligament. The doctor dissects it and partially removes it. Often, with a prolonged course of the disease, there are fusion of the tendon with the tendon sheath. In this case, all available adhesions are excised. The wound is sewn, a bandage dressing is applied. Sutures are removed after about 10 days, the work capacity is finally restored to 15 days.

It is necessary to take into account that de Kerven (disease) is usually due to the pathological process in the zone of the ring-shaped ligament. If, after direct surgical intervention, the patient continues to overload the hand, the likelihood of recurrence increases several times. That's why patients are recommended to reduce activity, and sometimes even completely change the type of professional activity.

Possible complications

What will happen if you do not treat de Carven's disease? Hands over time are increasingly involved in the pathological process, and a person loses his habitual ability to work. That is why it is so important if you have primary symptoms that indicate an ailment, seek qualified help from an appropriate specialist. In the case of surgical intervention, there is still a small probability of occurrence of such complications as the formation of a painful scar and violation of the movements of the thumb.

Preventive measures

How to prevent the development of the disease? First of all, doctors recommend that all those who are at risk, reduce the physical strain associated with grasping movements of the brush. In addition, do not start the disease of the joints of inflammatory nature. In case of trauma or mechanical damage to the hand, it is important to seek help from a doctor and take a course of therapy. Only by following all the above recommendations can the development of pathology be prevented.

Conclusion

In this article, we described what symptoms are accompanied by de Kerven's disease. Operation with such a pathology is recommended in 80% of cases. However, timely begun conservative treatment can eliminate the ailment and minimize the development of complications.

We hope that all the information provided will be useful for you. Be healthy!