Application of mechanical diagnosis and therapy to a patient diagnosed with de Quervain's disease: a case study

J Hand Ther. 2009 Jul-Sep;22(3):278-83; quiz 284. doi: 10.1016/j.jht.2009.03.002. Epub 2009 May 27.


Study design: Single case report.

Introduction: Mechanical diagnosis and therapy (MDT) is widely used in the management of both spinal disorders and extremity problems. However, there is no study that has introduced the application of this concept to hand therapy.

Purpose of the study: To demonstrate the application of MDT to a patient with a thumb problem, which was diagnosed as de Quervain's disease.

Methods: According to MDT principles, the thumb pain was assessed and treated.

Results: Radio carpal joint distraction with thumb metaphalangeal flexion combined with wrist ulnar deviation was found as the directional preference, which abolished the thumb pain. After the repeated movements Finkelstein test and tenderness to pressure became negative.

Conclusions: A patient apparently presenting with de Quervain's disease was classified as derangement syndrome using MDT. The pain was rapidly and successfully treated with self-management exercises.

Level of evidence: 4.

Publication types

  • Case Reports

MeSH terms

  • De Quervain Disease / classification
  • De Quervain Disease / diagnosis*
  • De Quervain Disease / therapy*
  • Female
  • Humans
  • Middle Aged
  • Movement
  • Physical Examination / methods*
  • Physical Therapy Modalities*