[Mommy Thumb/De Quervain's Disease] [Transarterial Microembolization (TAME)] Successful Case Sharing

Ms. C, 44 years old, suffered from persistent swelling and pain on the thumb side of her left wrist, especially when twisting her wrist, severely impacting her quality of life and sleep. Even after medication, rehabilitation, wearing a wrist brace, and multiple injections, the pain remained unbearable. Her pain score was 6-7 out of 10.

Based on medical history and physical examination (Finkelstein's Test), Bow Wang, M.D. was diagnosed with "Mommy Thumb/De Quervain's Disease." Examinations of ultrasound and magnetic resonance imaging (MRI) also showed inflammation and swelling of the tendons of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) muscles, as well as the surrounding synovium.

Following discussion, Bow Wang, M.D. was used on Ms. C. Guided by X-ray fluoroscopy and ultrasound, under local anesthesia and arterial angiography, Bow Wang, M.D. injected contrast agent to identify excessively proliferating and disordered capillary-like vessels in the inflamed and swollen area. Embolizing medication was then injected via a microcatheter to remove these abnormal capillary-like vessels.

Two weeks after treatment, Ms. C's swelling on the radial side of her wrist significantly improved, her pain score dropped dramatically from 6-7 to 0-1, her range of motion also improved significantly, and her quality of life significantly increased.

**Stenosing tenosynovitis**, also known as De Quervain's tenosynovitis, commonly called "Mommy's Thumb," is not exclusive to mothers; it's a common problem among those who repetitively use their wrists.

This is mainly caused by repetitive, manual work activities, especially with the thumb. The abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons rub excessively at the point where they cross the radial side of the wrist, causing inflammation of the synovial membrane. This leads to swelling, pain, and even affects daily activities, including holding a child, typing, and using a mobile phone.

Clinically, a simple test can help doctors confirm whether someone has "mommy's thumb," namely the well-known Finkelstein Test:

Treatment for De Quervain's Syndrome includes rest, medication, physical therapy, braces, and local injections. Recent literature shows that chronic inflammation results in disordered proliferation of capillary-like microarteries and associated pain nerves. Transarterial Microembolization (TAME) achieves anti-inflammatory, swelling-reducing, and analgesic effects by embolizing and clearing these disordered capillary-like microarteries.

However, Bow Wang, M.D. reminds you that Transarterial Microembolization (TAME) treatment also has limitations. Its main indications are a pain index exceeding 5 points, and patients who have not seen significant improvement after more than three months of various traditional treatments. Continued rehabilitation is recommended after treatment.