ESR usually normal
Consider arthrocentesis for joint effusion to evaluate for crystals, gram stain, culture
Plain films usually nondiagnostic
May see soft tissue swelling or radial styloid sclerosis or erosion
Important to rule out fracture, gas formation, late osteomyelitis
US diagnostic
Thickened extensor retinaculum (>0.45mm) overlying radial styloid
Thickened APL and EPB under extensor retinaculum, as contrasted with unaffected wrist
Edema surrounding tendons within first dorsal wrist compartment
Surrounding hyperemia on Doppler within peritendinous subcutaneous area
Intertendinous septum (hypoechoic area between EPB and APL) increases need for operative management
May see soft tissue swelling or radial styloid sclerosis or erosion
Important to rule out fracture, gas formation, late osteomyelitis
Thickened extensor retinaculum (>0.45mm) overlying radial styloid
Thickened APL and EPB under extensor retinaculum, as contrasted with unaffected wrist
Edema surrounding tendons within first dorsal wrist compartment
Surrounding hyperemia on Doppler within peritendinous subcutaneous area
Intertendinous septum (hypoechoic area between EPB and APL) increases need for operative management
De Quervain tenosynovitis
Distal finger
Morton's neuroma
Finger amputation
Nursemaid's elbow
Fingertip laceration
Flexor tenosynovitis
Nail avulsion