De quervain's tenosynovitis and occupation: an epidemiological study

ABSTRACT

A cross - sectional study was carried out in five different occupational settings in City to determine the prevalence of de Quervain's tenosynovitis among workers performing repetitive hand and thumb movements and to identify the potential associated risk factors. Washer women, brick layers, nurses and computer keyboard operators were selected randomly as the exposed group and compared with a group of randomly selected non-exposed workers. A total number of one-hundred and fifty six workers were interviewed using a preconstructed questionnaire. Those workers who were diagnosed as de Quervain's tenosynovitis by clinical manifestations and positive Finklestein's test were subjected to magnetic resonance imaging [MRI] of the wrist. The results revealed that the highest prevalence of de Quervain's tenosynovitis was among washer women [36.4%] and brick layers [30.8%] followed by nurses [17.6%] then computer keyboard operators [15.3%] and the least was 1.3% among the non-exposed group. De Quervain's tenosynovitis symptoms were more frequently reported among exposed workers [59%] compared to the non-exposed [7.7%]. Among those complaining of symptoms suggestive of de Quervain's tenosynovitis, 12.8% were diagnosed as de Quervain's disease by Finklestein's test. MR imaging revealed that increased tendon thickness and thickening and edema of the synovial sheath were the most reliable findings. Multivariate logistic regression analysis revealed that the type of current occupation, actual hours worked per day, older age and female gender were likely to be associated with de Quervain's tenosynovitis. In conclusion, exposure to heavy manual work load in occupations that need repetitive hand motions alone or with forceful squeezing, forceful gripping and/or forceful grasping and turning were associaled with high prevalence of de Quervain's tenosynovitis. This condition was also related more to age, sex and actual hours worked per day. So, administrative regulations and surveillance for de Quervain's tenosynovitis in the work place may be of great benefit for early referral of cases for treatment and to reduce the occurrence of the condition