de Quervain’s Tenosynovitis with Accessory Abductor Pollicis Longus Tendon and ‘Wartenberg’s syndrome’ - A Case Report

Background: de Quervain's tenosynovitis (dQT) is focal soft-tissue rheumatism of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. The Swiss surgeon Fritz de Quervain first demonstrated the disorder in 1895. Anatomical variation of the first wrist extensor compartment, for example, accessory APL, can be associated with de Quervain's tenosynovitis. Sometimes, dQT may coexist with superficial radial nerve (SRN) compression, widely known as 'Wartenberg’s syndrome'. Case Presentation: In the present case study, clinical features of de Quervain's tenosynovitis have been described in a 45-year-old housewife without any known risk factor for the disorder. The patient complained of pain and swelling on the radial aspect of dorsal wrist; there was local tenderness, and the Finkelstein test was positive. An ultrasonogram of the wrist's first extensor compartment depicted a thick, hypoechoic tenosynovial sheath encircling two APL and one EPB tendon. Swollen first extensor wrist compartment compressing the SRN led to tingling and dysesthesia, 'Wartenberg’s syndrome.' Conclusion: de Quervain's tenosynovitis with accessory abductor pollicis longus tendon may present with ‘Wartenberg’s syndrome’.