Scientific article
Incidence of de Quervain's Tenosynovitis in a Young, Active Population

https://doi.org/10.1016/j.jhsa.2008.08.020Get rights and content

Purpose

De Quervain's tenosynovitis is thought to occur most frequently in women, with presentation of pain and swelling in the first dorsal extensor sheath. The epidemiology of this extensor tendinitis is not well described. We evaluated the incidence and demographic risk factors for de Quervain's tenosynovitis using a large database of military personnel.

Methods

The Defense Medical Epidemiology Database (DMED) collects International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9-CM) coding information for every patient encounter occurring for United States military personnel. We queried the DMED system by race, gender, military service, rank, and age for the years 1998–2006 using the ICD-9 code 727.04, limiting data to first presentations. Multivariate Poisson regression was used to estimate the rate of de Quervain's tenosynovitis per 1000 person-years, as well as incidence rate ratios and 95% confidence intervals.

Results

There were 11,332 cases of de Quervain's tenosynovitis in the population at risk of 12,117,749 person-years. Women had a significantly higher rate of de Quervain's tenosynovitis at 2.8 cases per 1000 person-years, compared to men at 0.6 per 1000 person-years. Age greater than 40 was also a significant risk factor, with this age category showing a rate of 2.0 per 1000 person-years compared to 0.6 per 1000 in personnel under 20 years. There was also a racial difference, with blacks affected at 1.3 per 1000 person-years compared to whites at 0.8.

Conclusions

In analysis of a large population, we have described the epidemiology of stenosing tenosynovitis of the first extensor compartment. Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race.

Type of study/level of evidence

Prognostic II.

Section snippets

Materials and Methods

The Defense Medical Epidemiology Database (DMED) maintains ICD-9-CM coding information for every patient encounter occurring in the population of active duty U.S. service members. The DMED database also incorporates the total number of U.S. service members on active duty at any given time. This database also contains patient demographic and military-specific data that may be used for epidemiological purposes.

To determine the total number of presentations of de Quervain's disease, we queried the

Results

A total of 11,332 cases of de Quervain's tenosynovitis were documented in our population at risk of 12,117,749 person-years. This equates to an unadjusted incidence rate in our population of 0.94 per 1000 person-years.

The effect of gender as a demographic risk factor was significant. The unadjusted incidence rate for male patients was 0.62 per 1000 person-years, compared with 2.81 for female patients (p < .0001). The adjusted incidence rate ratio for females, with male patients as the referent

Discussion

Despite its frequent presentation as an upper extremity musculoskeletal problem, the epidemiology of de Quervain's tenosynovitis is not well known. It is thought to occur more frequently in women between the ages of 20 and 40,8 including the variant that occurs during pregnancy and the postpartum period.9 Beyond this, little information on the demographic distribution of de Quervain's disease is available. In an industrial medicine study, Thompson et al. noted that 544 factory workers (in a

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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or United States government. Some of the authors are employees of the U.S. government.

No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.

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