Radiographic evaluation of radial styloid features in de Quervain's tenosynovitis: a case-control study.

Abstract

Purpose: De Quervain's tenosynovitis (DQV) is a common tendinopathy characterized by inflammation of the first extensor compartment, resulting in pain on the radial side of the wrist. While clinical assessment is primarily utilized for diagnosis, radiographic imaging may be essential for ruling out alternative conditions. This study aimed to investigate specific radiographic measurements of the radial styloid and their correlation with DQV.

Methods: We conducted a matched case-control study at a tertiary university hospital in southern Thailand from August 2023 to March 2024, enrolling patients aged 18 years and older who were clinically diagnosed with DQV, characterized by tenderness at the radial styloid and a positive Finkelstein's test. The control group consisted of asymptomatic individuals or those with unrelated wrist pathologies, all of whom had normal radiographic findings. Key radiographic parameters assessed included the radial styloid height ratio, angle of prominence, and the area of the prominent styloid surface, using posteroanterior (PA) wrist radiographs.

Results: One hundred participants were analyzed, equally divided into case and control groups. Statistical comparisons indicated no significant differences in the assessed radiographic measurements between groups. The mean radial styloid height ratio was 0.23 ± 0.057 in the case group and 0.232 ± 0.078 in the control group (p = 0.892). The mean angle of radial styloid prominence was 12.6 ± 2.8 degrees in the case group versus 12.9 ± 3.8 degrees in the control group (p = 0.685). Additionally, the mean area of the radial styloid measured 128.3 ± 41.2 square millimeters in the case group compared to 114.5 ± 32.1 square millimeters in the control group (p = 0.099).

Conclusion: Although certain parameters showed trends suggesting a potential link between anatomical variations and DQV, none reached statistical significance. Future research should explore additional parameters that may better elucidate the diagnostic value of radiographic imaging in patients with de Quervain's tenosynovitis and inform clinical management strategies.