Not All De Quervains are De Quervains - A Rare Case Report

Acute calcific tendinitis is a benign, painful condition commonly described in the shoulder and frequently seen in diabetic patients, especially females. It is usually self-limiting and relieved with nonsteroidal anti-inflammatory drugs (NSAIDs), rarely requiring surgery. Calcific tendinitis involving the wrist is less common and often underdiagnosed, leading to improper treatment. Calcific tendinitis of the first extensor compartment of the wrist has not been previously reported and may be mistaken for De Quervain's Tenosynovitis or cellulitis. This case report aims to highlight this rare presentation to avoid diagnostic errors.

A 57-year-old diabetic female presented with a 2-week history of progressive severe pain over the dorsoradial aspect of the left wrist without trauma or fever. Initially diagnosed as De Quervain's Tenosynovitis with a positive Finkelstein test, she did not respond to NSAIDs and splinting. Radiographs revealed calcification at the base of the first metacarpal. Magnetic resonance imaging confirmed calcific tendinitis of the first extensor compartment. Surgical release revealed chalky white calcium phosphate deposits. Post-operatively, the patient had complete symptom resolution and regained full, pain-free wrist movement.

Although rare, acute calcific tendinitis of the wrist can mimic De Quervain's Tenosynovitis. Radiographic evaluation is essential when symptoms persist despite conservative treatment. Prompt diagnosis and surgical intervention can reduce morbidity and avoid prolonged unnecessary NSAID and antibiotic use.