title: Application of mechanical diagnosis and therapy to a patient diagnosed with de Quervain's disease: a case study.
abstract: METHODS
  Single case report.
  
  
  BACKGROUND
  Mechanical diagnosis and therapy (MDT) is widely used in the management of both spinal disorders and extremity problems. However, there is no study that has introduced the application of this concept to hand therapy.
  
  
  OBJECTIVE
  To demonstrate the application of MDT to a patient with a thumb problem, which was diagnosed as de Quervain's disease.
  
  
  METHODS
  According to MDT principles, the thumb pain was assessed and treated.
  
  
  RESULTS
  Radio carpal joint distraction with thumb metaphalangeal flexion combined with wrist ulnar deviation was found as the directional preference, which abolished the thumb pain. After the repeated movements Finkelstein test and tenderness to pressure became negative.
  
  
  CONCLUSIONS
  A patient apparently presenting with de Quervain's disease was classified as derangement syndrome using MDT. The pain was rapidly and successfully treated with self-management exercises.
  
  
  METHODS
  4.
authors.affiliation: Shinoro Orthopedic, 4-5-3-9, Shinoro, Kita-ku, Sapporo, Hokkaido, Japan. habataku23@yahoo.com.jp
authors.forename: Shouta
authors.initials: S
authors.lastname: Kaneko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takasaki
authors.forename: Stephen
authors.initials: S
authors.lastname: May
mesh_terms: D053684:De Quervain Disease / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009068:Movement; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities