The patient experiences an insidious onset of difficulty with tasks such as opening jars because of pain localized to the dorsoradial aspect of the wrist that is exacerbated with thumb and wrist motion, and which may also be present on awakening.

 

On examination, the first dorsal compartment over the radial styloid is thickened and tender to palpation. Crepitus of the tendon may be felt on active and passive thumb motion. Tenderness will be elicited on palpating or stretching the extensor pollicis brevis and abductor pollicis longus tendons bordering the palmar side or, less commonly, the extensor pollicis longus tendon bordering the dorsal side of the anatomic snuff box (Fig. 105.1).