Focal radial styloid abnormality as a manifestation of de Quervain tenosynovitis

OBJECTIVE. De Quervain disease is a stenosing tenosynovitis of the first do rsal wrist compartment. The purpose of this study was to determine whether focal radial styloid abnormality (cortical erosion, sclerosis, or periostea l bone apposition) as shown by radiography can be an indicator of de Querva in tenosynovitis. MATERIALS AND METHODS. A retrospective review of 49 radiographs from 45 pat ients in whom the clinical diagnosis of de Quervain tenosynovitis was confi rmed (positive findings on Finkelstein's test) and 64 radiographs from 62 a symptomatic patients was carried out independently by two musculoskeletal r adiologists in a blinded fashion. Findings on radiographs were assessed for focal radial styloid abnormality and assigned a diagnostic grade (1, defin itely normal; 2, probably normal; 3, equivocal; 4, probably abnormal; 5, de finitely abnormal). Receiver operating characteristic curves were construct ed and compared. Kappa, statistics for interobserver and intraobserver vari ability were calculated. RESULTS. The presence of focal radial styloid abnormality correlated signif icantly with the presence of de Quervain tenosynovitis (p < 0.05). The area s under the receiver operating characteristic curves for each reviewer equa led 0.71 and 0.76. Kappa values for interobserver variability equaled 0.44 (moderate agreement), and intraobserver variability equaled 0.62 (substanti al agreement). CONCLUSION. Focal radial styloid abnormality is an indicator of de Quervain stenosing tenosynovitis of the wrist.