How is De Quervain’s tenosynovitis treated?

De Quervain's tenosynovitis or tendovaginitis is treated in 3 ways:1. Oral non-steroidal anti-inflammatory drugs (NSAIDs) and splinting2. Corticosteroid injections3. SurgeryMost patients will follow a step-wise approach, going on to the next optiononce the previous one has failed.

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Answered By

Dr Aaron Gan

Hand Surgeon

What kind of sports can worsen a preexisting carpal tunnel syndrome?

Technically, all sports which involve the use of the hand and wrist can worsen a pre-existing carpal tunnel syndrome. In fact, any form of repetitive movement done from the wrist over an extended period can make carpal tunnel syndrome worse. These movements lead to swelling and compression of the median nerve [1].

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Answered By

Dr Aaron Gan

Hand Surgeon

How do I get rid of wrist discomfort that had no preceding trigger?

There can be several causes of wrist discomfort, including joint, tendon, or ligament problems. If there is no preceeding trigger ( ie. I would presume trauma/ fall/ extreme heavy laods), it would unlikely be a fracture. Pain on the thumb side of the wrist, commonly can be due to a tendon overuse problem, eg De Quervains tenosynovitis. If the discomfort is persistent and not going away, it would be important for you to seek a consultation with an orthopaedic surgeon. A thorough examination of your hand/ wrist and forearm would need to be done.

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Answered By

Dr Sean Ng

Orthopaedic Surgeon

Why is there a hard bump below my ring finger? (photo)

From the photo, there is no obvious lump seen. This lump is likely to be located deeper beneath the skin. Some possibilities include an underlying cyst, swelling of the tendon sheath, or ganglion. It is advisable for you to see your doctor for a closer examination and palpation for a more accurate diagnosis.

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Answered By

Dr Colin Theng

Dermatologist

What could be the cause of a painful lump near the wrist area? (photo)

Unfortunately, the swelling is not very obvious from the clinical photograph. I think for a proper diagnosis, you should get this checked out by your doctor. Some comon causes of swelling around the wrist include a ganglion. But you will require a close examination to make the diagnosis.

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Answered By

Dr Colin Theng

Dermatologist

When should I seek medical attention after a finger injury?

Hi, Sorry to hear about your thumb - sounds painful! As Dr Sean mentions, if you have persistent symptoms it is probably worth seeking an assessment and an X-ray as the minimum investigation. Sometimes, in the clinic, we also perform an ultrasound examination to look for ligament and tendon injuries. Depending on the findings, treatments can vary from simple splinting to rehab, injections or even surgical treatment. If this has affected your dominant hand or is causing a significant functional issue, I would suggest a more urgent assessment.

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Answered By

Dr Dinesh Sirisena

Sport Medicine

What could be the cause of right shoulder blade pain that is associated with a cracking sound?

This is a common problem particularly in younger patients and we have had a number come into the Sports Clinic with these symptoms. Often it is not due to a tendon or muscle issue but comes from a scapulo-thoracic bursa. This is a potential space that sits between your shoulder blade and chest wall that allows your shoulderblad to move freely. Sometimes when inflamed, it causes cracking and pain. The first thing to do is to make sure that this is indeed th cause with a clinical assessment and maybe an ultrasound examination of the shoulder.

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Answered By

Dr Dinesh Sirisena

Sport Medicine

What is the cause for sore and stiff fingers, and which specialist should I see in Singapore?

thank you for your question. Although arthritis might be a cause of your symptoms, there are other conditions that can account for your symptoms such as a simple sprain of the joints of the fingers (from your exercise, from using computers etc). Furthermore, there are many subclasses of arthritis (rheumatoid, osteoarthritis, gouty arthritis etc) and many conditions that can cause arthritis as part of the disease process including SLE. It will be difficult to diagnose based on your submitted history, as a more elaborate history and physical examination may be required.

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Answered By

Dr Tzeyeong Teng

General Practitioner

How will joint replacement surgery (replacement arthroplasty) affect my lifestyle?

I assume that you are referring specifically to the replacement of the 1st carpometacarpal joint. After such a replacement is done, you can expect a better quality of life. Pain should be eliminated almost immediately, and joint motion will improve with the presence of the new joint. Certainly, the pinch strength of the thumb after replacement will not match that of a completely normal thumb, although it will be stronger than what it is before surgery. The ability to play musical instruments, using the computer and mobile devices will post-surgery.

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Answered By

Dr Aaron Gan

Hand Surgeon

How is trigger finger treated in Singapore?

There are 3 ways to treat trigger fingers: Splinting, hand occupational therapy and non-steroidal anti-inflammatory medications. These aim to relieve the inflammation around the involved tendon, mobilise and prevent adhesions from forming between the tendons. Corticosteroid injections. These are very effective and quick in relieving the pain and inflammation around the tendons that cause the triggering of the finger. Trigger finger can recur after treatments 1 and 2. Surgery.

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Answered By

Dr Aaron Gan

Hand Surgeon

How is arthritis diagnosed in a young female with aching finger joints?

Dr Henry has already provided an excellent summary to the different types of arthritis that can occur. Just wanted to add that the cyst could be a simple ganglion from your computer use. Sometimes with excessive pressure, these can develop and the easiest way to manage them is simply to modify your activities. You can certainly see a surgical colleague, but an alternative might be to see a primary care physician for a general assessment, including blood tests etc. , before seeing a rheumatologist or MSK/Sports physician.

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Answered By

Dr Dinesh Sirisena

Sport Medicine

For Madelung deformity, what are the available treatments in Singapore?

Madelung deformity is a congenital deformity affecting the forearm bone and this results in a bowed appearance of the upper extremity. The only treatment available is surgery to correct the deformity. This usually involves cutting the deformed bone and re-shaping it to correct the deformity. Bone grafts are frequently required and metal implants such as plates, screws and wires will be used to secure the bone in its new position until the bone ends unite.

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Answered By

Dr Aaron Gan

Hand Surgeon

What should I do next if my wrist has not recovered completely after a fall?

Yes, what Dr Dinesh said holds true. I think if you have persistent wrist pain despite a “normal” X-ray, we have to consider other potential problems. 1. Sometime very small minute cracks/ microfractures may not be seen on a standard X-ray. It may be necessary to do a more detailed radiological investigation - an MRI. This can pick up hairline fractures or bony oedema (swelling). 2. Injury to other hand/ carpal bones. Like the scaphoid bone. We usually order specific scaphoid X-ray views to look for a scaphoid fracture. A wrist X-ray may not be adequate.

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Answered By

Dr Sean Ng

Orthopaedic Surgeon

What could be the cause of a hard bump on my left thumb joint?

Thank you for the email. From the picture, this does look like a digital myxoid cyst. This usually occurs over the distal finger joints and may be associated with underlying osteoarthritis. The cyst may have a connection with the underlying joint. Some simple treatments includes rubbing and pressure over the area and freezing it with liquid nitrogen treatment, but the recurrent rates are high. Definitive treatment is through surgical excision of the lump.

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Answered By

Dr Colin Theng

Dermatologist

How do I know if my wrist is sprained or fractured?

Fractures usually present with more swelling than sprains, although not always. If an obvious deformity is seen, there is a higher likelihood of the presence of a fracture. The most important investigation to differentiate the 2 conditions is an X-ray.

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Answered By

Dr Aaron Gan

Hand Surgeon

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