There is an association between the postpartum state and de Quervain’s tenosynovitis. De Quervain’s is a pathologic process of the 1st dorsal (extensor) compartment which contains the extensor pollicis brevis and abductor pollicis longus tendons. The best choice is #3 because of the very common and known association of postpartum state and de Quervain’s as well as the potential for resolution with appropriately placed steroid injection. Answer #1 refers to basal joint arthritis which is typically seen in older patients. Answer #2 refers to carpal tunnel syndrome, which would present with paresthesias in the median nerve distribution. Answer #4 refers to a trigger thumb. Answer #5 alludes to intersection syndrome which is generally more proximal to the wrist and results from inflammation at crossing point of 1st dorsal compartment (APL and EPB) and 2nd dorsal compartment (ECRL, ECRB). To review, the wrist extensor compartments (from radial to ulnar) are: 1) APL & EPB; 2) ECRL & ECRB (common radial wrist extensors); 3) EPL; 4) EIP & EDC; 5) EDM; 6) ECU.
Wolfe SW:Tenosynovitis, In Green DP, Hotchkiss RN,Pedereson WC, et al (eds): Green's Operative Hand Surgery, Edition 5, Philadephia, PA Elsevier, 2005, PP 2137-2158
Schned ES. DeQuervain tenosynovitis in pregnant and postpartum women. ObstetGynecol. 1986 Sep;68(3):411-4.
PMID:3488531 (Link to Abstract)