title: de Quervain disease: US identification of anatomic variations in the first extensor compartment with an emphasis on subcompartmentalization.
abstract: OBJECTIVE
  To demonstrate the usefulness of ultrasonography (US) in the detection of anatomic variations in the first extensor compartment of the wrist in patients with de Quervain disease.
  
  
  METHODS
  The institutional review board approved this study protocol and waived the informed consent requirement. Fifteen wrists in 13 women (age range, 41-62 years) in whom de Quervain disease was clinically diagnosed and who underwent surgery for intractable pain were included. A musculoskeletal radiologist performed US before surgery. The absence or presence and extent of subcompartmentalization within the first extensor compartment and the number of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slips were evaluated and recorded. Preoperative US findings were compared with surgical records and photographs.
  
  
  RESULTS
  Subcompartmentalization within the first extensor compartment was observed during surgery in 11 of the 15 wrists (73%), including four (27%) that had subcompartmentalization only in the distal portion of this compartment. US was used to identify all 11 wrists showing subcompartmentalization within this compartment (sensitivity, 100%; 95% confidence interval [CI]: 74%, 100%), as well as three of the four wrists with distal incomplete subcompartmentalization. There was one wrist with false-positive distal incomplete subcompartmentalization. US had a positive predictive value in the detection of subcompartmentalization of 73% (95% CI: 47%, 91%). The number of tendon slips in this compartment detected with US was identical to that identified at surgery with one exception.
  
  
  CONCLUSIONS
  US can be used to depict various types of anatomic variations in the first extensor compartment in patients with de Quervain disease.
authors: Department of Radiology, Asan Foundation, Gangneung Asan Hospital, University of Ulsan College of Medicine, 415 Bangdong-ri, Sacheon-Myeon, Gangneung-si, Gangwon-do 210-711, Korea. sjchoi@gnah.co.kr
authors: Soo-Jung
authors: SJ
authors: Choi
authors: Jae Hong
authors: JH
authors: Ahn
authors: Young-Jun
authors: YJ
authors: Lee
authors: Dae Sik
authors: DS
authors: Ryu
authors: Jong Hyeog
authors: JH
authors: Lee
authors: Seung Moon
authors: SM
authors: Jung
authors: Man Soo
authors: MS
authors: Park
authors: Ki Won
authors: KW
authors: Lee