anatomical snuff box

[astrov]

I work at landscaping and construction. I have been suffering a little bit of pain in my left hand for a few weeks. I couldn't pull down on it without pain, and my grip strength and range of motion were compromised. But it was never so bad that I needed immediate attention. I was planning on having it looked at on October 1st when my medical insurance coverage resumes. A few days ago, in a spirited game of foosball, I lost myself to the game and in a moment of passion, snapped something in my left wrist. It hurt. I am trying to figure out if I had earlier broken my scaphoid bone or if I have just recently severed the extensor pollicis brevis tendon, the tendon that forms the lower part of the "anatomical snuff box". I say this because the anatomical snuff box on my left hand is missing. That is, I can no longer form the snuffbox with my left hand, even with my thumb extended. So it's like the tendon has snapped, or stretched out to form some much weaker version of its former self. And yet, just sitting here, there's no pain. But if I press on the scaphoid bone, it hurts like a mother. I don't know if the tendon problem would come along with the bone problem. The doctor looked at it really quickly and told me to get an MRI to have a look at the tendon. Well, that would cost 500-600 dollars if I went in before October 1st. I'd prefer to rely on the wisdom, experience, and quackery found on cc.com for a diagnosis. Has anyone had any experience with tendinitis (or worse) in this tendon, or else broken a scaphiod bone? I would like to get this fixed up soon, if that's possible, so I can climb in New Hampshire this fall ...

[layton]

check into something called (and i think i may spell it wrong) Dequarvine's contracture. sounds like it.

 

ice, ultrasound, stripping the extensors, ajusting the radius or scaphiod...blah blah blah,

 

radial n.a.v. pass that away too, and of course the schaphoid. need to narrow it down. see a doctor, chiro, or orthopod and get diagnosed.

[mneagle]

 

You are thinking of deQuervain’s tenosynovitis. (It's Dupuytren's that had the contracture named after him). The physical exam test is my favorite in all of medicine, the "Finkelstein Test". Wrap your fingers around your thumb as above and flex the wrist down like you are milking a cow. If the tendon is inflammed pain will radiate up your forearm from the thumb. A steroid injection can fix it fast but has the increased risk of tendon rupture. Rest, ice, etc is probably safer.

[astrov]

hey, yeah ... I can't make that with sore old lefty.

[layton]

 

You are thinking of deQuervain’s tenosynovitis. (It's Dupuytren's that had the contracture named after him). The physical exam test is my favorite in all of medicine, the "Finkelstein Test". Wrap your fingers around your thumb as above and flex the wrist down like you are milking a cow. If the tendon is inflammed pain will radiate up your forearm from the thumb. A steroid injection can fix it fast but has the increased risk of tendon rupture. Rest, ice, etc is probably safer.

 

yeah, that's what i meant. sorry didn't have my notes and i've pretty much forgotten everthing i know after climbing all summer.