Wolf Jennifer Moriatis, Sturdivant Rodney X, Owens Brett D
Department of Orthopaedics, University of Colorado School of Medicine, Denver, Colorado 80045, USA.
J Hand Surg Am. 2009 Jan;34(1):112-5. doi: 10.1016/j.jhsa.2008.08.020. Epub 2008 Dec 10.
De Quervain's tenosynovitis is thought to occur most frequently in women, with presentation of pain and swelling in the first dorsal extensor sheath. The epidemiology of this extensor tendinitis is not well described. We evaluated the incidence and demographic risk factors for de Quervain's tenosynovitis using a large database of military personnel.
The Defense Medical Epidemiology Database (DMED) collects International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9-CM) coding information for every patient encounter occurring for United States military personnel. We queried the DMED system by race, gender, military service, rank, and age for the years 1998-2006 using the ICD-9 code 727.04, limiting data to first presentations. Multivariate Poisson regression was used to estimate the rate of de Quervain's tenosynovitis per 1000 person-years, as well as incidence rate ratios and 95% confidence intervals.
There were 11,332 cases of de Quervain's tenosynovitis in the population at risk of 12,117,749 person-years. Women had a significantly higher rate of de Quervain's tenosynovitis at 2.8 cases per 1000 person-years, compared to men at 0.6 per 1000 person-years. Age greater than 40 was also a significant risk factor, with this age category showing a rate of 2.0 per 1000 person-years compared to 0.6 per 1000 in personnel under 20 years. There was also a racial difference, with blacks affected at 1.3 per 1000 person-years compared to whites at 0.8.
In analysis of a large population, we have described the epidemiology of stenosing tenosynovitis of the first extensor compartment. Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
桡骨茎突狭窄性腱鞘炎被认为在女性中最为常见，表现为第一背侧伸肌鞘的疼痛和肿胀。这种伸肌腱炎的流行病学情况尚无详尽描述。我们利用一个大型军事人员数据库评估了桡骨茎突狭窄性腱鞘炎的发病率及人口统计学风险因素。
国防医疗流行病学数据库（DMED）收集美国军事人员每次就诊的国际疾病分类第九版临床修订本（ICD - 9 - CM）编码信息。我们在1998 - 2006年期间，使用ICD - 9编码727.04，按种族、性别、军种、军衔和年龄查询DMED系统，数据仅限于首次发病情况。采用多变量泊松回归来估计每1000人年的桡骨茎突狭窄性腱鞘炎发病率，以及发病率比和95%置信区间。
在12,117,749人年的危险人群中，有11,332例桡骨茎突狭窄性腱鞘炎病例。女性的桡骨茎突狭窄性腱鞘炎发病率显著更高，为每1000人年2.8例，而男性为每1000人年0.6例。年龄大于40岁也是一个显著的风险因素，该年龄组的发病率为每1000人年2.0例，而20岁以下人员为每1000人年0.6例。还存在种族差异，黑人的发病率为每1000人年1.3例，而白人是每1000人年0.8例。
通过对大量人群的分析，我们描述了第一伸肌间隔狭窄性腱鞘炎的流行病学情况。我们人群中桡骨茎突狭窄性腱鞘炎的风险因素包括女性、年龄大于40岁和黑人种族。
研究类型/证据水平：预后性II级
