Tendonitis of the hand and wrist is a common upper extremity disorder. Tendonitis should not be used as a “waste basket” term to diagnose generalized wrist and hand pain, but should refer to a specific anatomic site. Three common tendon afflictions are tenosynovitis, tenovaginitis, and tendinosis. Any tendon or group of tendons that have a synovial lining can become inflamed (tenosynovitis). A tendon can be constricted by a tight covering or sheath (tenovaginitis). A tendon origin or insertion can become diseased or degenerated secondary to age, poor blood supply, friction, or overuse (tendinosis). The three conditions may occur as independent entities or in combination.

De Quervain’s tendonitis refers to involvement of the tendons of the first dorsal compartment (abductor pollicis longus [APL] and the extensor pollicis brevis [EPB] tendons). Within the compartment, the APL has multiple tendinous slips and is often separated from the EPB by a septum. De Quervain’s tendonitis is associated with repetitive tasks involving the thumb and wrist, as well as with pregnancy and childcare. Patients have tenderness over the first dorsal compartment and pain during a Finkelstein’s test (asking the patient to fully flex the thumb and passively move the wrist into ulnar deviation). This maneuver is positive if it reproduces the patient’s discomfort. Typically, active thumb abduction and extension against resistance is painful. The differential diagnosis for radial-sided wrist pain includes thumb carpometacarpal or scaphotrapezoid joint arthritis, scaphoid fracture or nonunion, radiocarpal arthritis, radial styloid fracture, and radial sensory neuritis (Wartenberg’s syndrome). An x-ray of the wrist should be obtained if there is any question about the diagnosis.