Sonographic Identification of the intracompartmental septum in de Quervain's disease.
BACKGROUND
The intracompartmental septum in the first extensor compartment in patients with de Quervain's disease has been associated with disease development and prognosis. However, with the exception of surgical exploration, there is no way of detecting the septum.


OBJECTIVE
We evaluated the accuracy of sonography for identifying the intracompartmental septum in the first extensor compartment in patients with de Quervain's disease using surgical findings as the reference standard.


METHODS
We performed surgical release of the first extensor compartment in 43 wrists of 40 patients who were unresponsive to nonoperative treatment. In each case, a sonographic evaluation was performed before surgery by a radiologist and the sonographic and surgical findings were compared.


RESULTS
Sonography identified the intracompartmental septum in 19 of the 19 septum-present wrists and absence of the septum in 23 of the 24 septum-absent wrists. The sensitivity of sonography was 100% (95% confidence interval, 80%-100%), its specificity 96% (95% confidence interval, 78%-100%), accuracy 98% (95% confidence interval, 87%-100%), positive predictive value 95% (95% confidence interval, 74%-100%), and negative predictive value 100% (95% confidence interval, 83%-100%). Sonography also identified septum-like structures in 15 of 37 (41%) asymptomatic contralateral wrists.


CONCLUSIONS
Sonography is useful for detecting the intracompartmental septum in the first extensor compartment in patients with de Quervain's disease.


METHODS
Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Kwon
Bong Cheol
BC
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Pyeongchon-dong Dongan-gu, Anyang-si Gyeonggi-do 431-070, South Korea. bckwon11@gmail.com
Choi
Soo-Joong
SJ
Koh
Sung Hye
SH
Shin
Dong Jo
DJ
Baek
Goo Hyun
GH
D000293:Adolescent; D000328:Adult; D000368:Aged; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000473:pathology; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D053684:De Quervain Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D014953:Wrist / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D055815:Young Adult