What are the signs and symptoms of dorsal wrist tenosynovitis in rheumatoid arthritis (RA) and how is it treated?

Updated: Jan 11, 2019
  • Author: Michael Neumeister, MD, FRCSC, FACS; Chief Editor: Joseph A Molnar, MD, PhD, FACS  more...
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Answer

Answer

Dorsal tenosynovitis in the wrist is usually detected when the dorsum of the wrist becomes swollen. Minimal pain may be present, but bogginess and crepitus can be appreciated with palpation. This swelling may even be the first sign of RA and may involve any combination of extensor tendons. In early cases, spontaneous remission can occur. Furthermore, rest, steroid injections, or medical management may induce remission. As dorsal tenosynovitis becomes more apparent, the likelihood of tendon rupture increases. Tenosynovectomy is usually recommended if symptoms do not improve after 4-6 months of medical therapy. After a tenosynovectomy, tendon rupture rarely occurs and complications are infrequent, yet postoperative adhesions may occur. Tendon adhesions result in an extensor lag of metacarpophalangeal (MP) joints or decreased active finger flexion.


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