De Quervain tenosynovitis is a stenosing condition of the first dorsal compartment causing significant radial wrist pain. In this Orthovellum masterclass, we explore the underlying myxoid degeneration, critical anatomical variations like the EPB septumand evidence-based management strategies. ⏱ Chapters 0:00 Intro 0:22 Essentials 0:56 Anatomy 1:33 Dorsal Compartments 2:06 Classification 2:36 Staging 3:14 Tests 3:55 Imaging 4:31 Algorithm 5:06 Surgical Technique 5:39 Complications 6:13 Clinical reasoning — Failure 6:40 Clinical reasoning — Injection This video provides a comprehensive overview of de Quervain tenosynovitis, moving beyond the historical misconception of primary inflammation to explain the true mechanical and degenerative pathophysiology. We cover everything from the classic presentation in postpartum women to the Shima anatomical classification, clinical severity stagingand the complete management algorithm from splinting and corticosteroid injections to surgical release. 🦴 IN THIS VIDEO YOU'LL LEARN • Understand the pathophysiology of myxoid degeneration and fibrocartilaginous thickening in the first dorsal compartment • Identify the contents of all six dorsal extensor compartments with a focus on the abductor pollicis longus and extensor pollicis brevis • Recognise the classic patient demographics, including the high prevalence in postpartum and lactating women • Perform the Finkelstein (Eichhoff) manoeuvre and the more specific WHAT test for clinical diagnosis • Differentiate de Quervain tenosynovitis from intersection syndrome, Wartenberg syndromeand basal thumb osteoarthritis • Apply the Shima cadaveric classification to identify the separate EPB subcompartment present in 30 to 50 percent of patients • Determine appropriate treatment pathways based on clinical severity staging from mild to severe disease • Execute the surgical release of the first dorsal compartment while protecting the superficial radial nerve • Prevent surgical failure by ensuring complete release of all subcompartments and septa ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ De Quervain tenosynovitis is a degenerative stenosing tenovaginitis, not a primary inflammatory synovitis. ✔️ The Finkelstein test (fist over thumb with ulnar deviation) is pathognomonic and sufficient for clinical diagnosis. ✔️ Corticosteroid injection into the tendon sheath is the first-line therapy for moderate disease with a 70 to 80 percent success rate. ✔️ A separate septum creating a hidden subcompartment for the extensor pollicis brevis is present in up to 50 percent of patients. ✔️ Failing to identify and release a separate EPB subcompartment is the most common cause of failed surgical management. ✔️ The superficial radial nerve crosses the surgical field in roughly 60 percent of cases and must be carefully protected to prevent neuroma. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, junior doctorsand medical students seeking a high-yield understanding of hand and wrist pathology. It is also highly valuable for physiotherapists, general practitionersand curious patients wanting a detailed breakdown of radial wrist pain and its management. 📚 RELATED TOPICS: Intersection Syndrome of the Wrist · Wartenberg Syndrome (Superficial Radial Nerve Entrapment) · Basal Thumb Osteoarthritis · Dorsal Extensor Compartments of the Wrist · Corticosteroid Injections in Hand Surgery · Stenosing Tenosynovitis Pathophysiology 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #dequervain #tenosynovitis #orthopaedics #handsurgery #finkelsteintest #radialwristpain #orthovellum #anatomy #medicaleducation #extensorcompartments #wristpain