Symptom screening for limited pain in the radial styloid process

Radial stenosis tenosynovitis is mainly characterized by limited pain in the radial styloid process. The disease starts slowly and worsens gradually, with pain at and around the thumb on the thumb side of the wrist (radial styloid process), obstruction of thumb movement, pressure and friction at the radial styloid process, and sometimes a slight elevated pea-sized nodule at the radial styloid process. If the thumb is held tightly within the other four fingers and the wrist is flexed to the medial (ulnar) side of the wrist, severe pain occurs at the radial styloid process. In the acute phase, there may be localized swelling. When the enlarged tendon passes through the narrow tendon sheath as a “tunnel”, the thumb will ring when it is flexed, which is also known as “ringing finger”. 1, general symptoms: The disease is common in domestic and manual workers, middle-aged and elderly women, the ratio of women to men is about 6:1, the onset of the disease is slow, the main manifestations are: the radial tuberosity limited pain, bulge; thumb extension is limited, the thumb to do a large extension and flexion activities produce pain, can be radiated to the hand, elbow, shoulder and other places. 2.Local symptoms: When examined, there is mild swelling at the radial styloid process, local pressure pain is obvious, sometimes a hard node can be palpated locally, or there is a rubbing sensation and rubbing sound when the thumb is abducted, a few can have a popping sound, Finkelstein’s (Finkelstein) sign is positive, that is, the thumb is flexed inward, the other four fingers hold the thumb in the palm, at this time the wrist joint is tilted to the ulnar side, the radial styloid process produces severe pain is positive, which is unique to this disease. This is a unique sign of the disease. Based on the medical history, clinical symptoms, physical signs and the characteristic sign – Finkelstein’s sign is positive, the diagnosis can be established. (1) Pain: Most of the patients cannot clearly identify the site of pain, but only complain of “twinge” in the joint, soreness and swelling in the joint during exercise or a feeling of inability to exert force. Sometimes the pain is band-like. (2) Localized swelling: The tendon may have striated bulges of varying degrees. (3) Dysfunction: Tenosynovitis in the wrist of the upper extremity affects the player’s power and sometimes deformation of movement when hitting the ball, and tenosynovitis in the ankle can be painful and affect movement when moving at pace. The tendon sheath is a sheath-like structure that surrounds the tendon. The outer layer is a fibrous tissue that attaches to the bone and adjacent tissues and serves to anchor and protect the tendon. The inner layer is synovial membrane which nourishes the tendon and secretes synovial fluid to facilitate the gliding of the tendon. Repeated excessive friction causes inflammation, edema, and thickening of the fibrous sheath wall of the tendon and tendon sheath to form a narrow ring, and the fibrosis and thickening of the tendon causes difficulty in sliding the tendon within the sheath, which is called stenosing tenosynovitis.