An intracompartmental septum within the first extensor compartment is a risk factor for de Quervain’s disease. The purpose of this study was to evaluate the accuracy of sonography to identify an intracompatmental septum in patients with de Quervain’s disease. The authors prospectively followed 40 patients (43 wrists) who had failed nonoperative management of de Quervain’s disease. An ultrasound examination was performed preoperatively in all wrists by a radiologist. Both the symptomatic and asymptomatic wrists were imaged. The presence or absence of an intracompartmental septum between the APL and EPB tendons was recorded. Surgical exploration and release of the first extensor compartment was then performed.
Ultrasonography identified an intracompartmental septum in all of the septum-present wrists (19 of 19) and identified the absence of a septum in 23 of the 24 septum-absent wrists. Sensitivity was 100% and specificity was 96%.
The authors have shown ultrasonography to be an accurate diagnostic tool in determining the presence or absence of an intracompartmental septum. However, sonography remains a highly user-dependent modality and may not be available at all centers. In addition, while interesting, this technique does not truly change the treatment algorithm of the condition as presented.