Volume 30, Issue 170, April 2026

Modern Perspectives on De Quervain’s Tenosynovitis: From Degenerative Pathogenesis to Ultrasound-Guided Management: A Narrative Review

Paweł Woś^♦, Bartłomiej Kowalski, Tomasz Kucharski, Daniel Dylko, Michał Szustakowski, Paweł Lewandowski, Jan Bogdański

Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Paweł Krzysztof Woś, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

ABSTRACT

De Quervain’s tenosynovitis (DQT) has evolved from an inflammatory occupational injury into a degenerative tendinosis. Our growing understanding of modern biomechanics, such as the “texting thumb” phenomenon in adolescents and the physical demands on primary caregivers, is driving this shift in clinical perspective. This study intends to describe changes in the etiology, anatomy, imaging, and management of DQT by summarizing the literature from the last 6 years. We detail the histopathological changes in DQT, specifically fibrocartilaginous metaplasia and irreversible bony changes, such as radial styloid sclerosis. A high incidence of an intracompartmental septum (up to 67%) represents a major factor in conservative treatment failure. We contrast the high recurrence rates of “blind” corticosteroid injections with the accuracy of ultrasound-guided (USG) injections, which yield results comparable to arthroscopic release. Furthermore, we show that USGpercutaneous release effectively treats patients experiencing recurrence after arthroscopic procedures. We explore the use of orthobiologics, such as Platelet-Rich Plasma (PRP), for chronic structural tendon damage, as well as the role of acupuncture in early rehabilitation. High-resolution ultrasound is our preferred modality for the modern treatment of DQT, and we advocate for patients to be part of shared decision-making to restore hand function and prevent recurrence.

Keywords: De Quervain’s tenosynovitis, radial styloid pain, ultrasound-guided injection, texting thumb, corticosteroid injection

Medical Science, 2026, 30, e72ms3847

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Published: 12 April 2026