A patient in her 30s suddenly develops pain and swelling in her wrist.

Treatment: Her wrist pain was treated though ultrasound guided injection in the office along with self-paced exercises and hand splint to prevent additional strain.

Outcome: Pain levels significantly decreased after the ultrasound-guided injection while increased strength with the hand and wrist self-paced exercises.

Details: A female patient in her 30s suddenly developed severe pain and swelling in her wrist. She had no specific injury to warrant her symptoms. The day before her symptoms started, she was taking down holiday lights from her house. During the holidays, she had also been using her hands and wrist more than usual. Her thumb and wrist were very painful to the touch, swollen, and slightly red. An ultrasound examination at the office showed swelling around the thumb tendons, called tenosynovitis. An ultrasound-guided injection of corticosteroid placed around the inflamed tendon relieved her pain. Patient was provided hand and wrist exercises to maintain normal joint function along with a splint to use during normal hand use. At the three-week follow-up, the patient continued to be pain-free while gradually increasing the use of the hand/wrist.

The main causes of Tenosynovitis are:

• Overuse of the wrist with repetitive motion such as typing, knitting, using tools, holding a baby, carrying heavy items, and many others
• Strain or injury to the wrist area
• Arthritis

Symptoms of Tenosynovitis:

• Pain at the side of your wrist under the base of your thumb. Moving your thumb can increase this pain.
• Wrist pain that has spread into your forearm and thumb.
• Mild swelling, redness, or warmth at your wrist.
• A fluid-filled cyst near the thumb side of your wrist.