Evidence Checklist: De Quervain's Tenosynovitis

Hand surgery or orthopedic evaluation with Finkelstein testCritical

Examination documenting positive Finkelstein test (pain with ulnar deviation of the wrist while the thumb is grasped in the fist), tenderness over the first dorsal compartment, and any palpable thickening of the APL/EPB tendons at the radial styloid.

Nexus opinion linking De Quervain's tenosynovitis to service ("at least as likely as not")Critical

A medical opinion connecting your first dorsal compartment tenosynovitis to repetitive thumb/wrist military duties (weapons handling, equipment operation, gripping) or a specific in-service wrist injury.

Wrist and thumb range of motion measurements

Documentation of wrist flexion, extension, radial and ulnar deviation, and thumb opposition and abduction in degrees, as pain-limited motion may support rating under the wrist or thumb schedule.

Diagnostic ultrasound of first dorsal compartment (if needed)

Ultrasound documenting tenosynovitis of the abductor pollicis longus (APL) and/or extensor pollicis brevis (EPB) tendons, including fluid in the tendon sheath and any anatomical variations (subcompartmentalization).

Documentation of dominant vs. non-dominant hand

Medical records specifying which wrist/thumb is affected and which hand is dominant.

Treatment records (splinting, corticosteroid injections, surgery)

Records documenting thumb spica splint use, corticosteroid injections into the first dorsal compartment sheath, and surgical first dorsal compartment release outcomes.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Hand and Finger ConditionsCritical

Standardized form capturing wrist and thumb range of motion, tendon findings, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.