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[T] Chung v. GTE Hawaiian Telephone Co.9/9/2004
dorsal compartment of the wrist, a sudden or acute hyperextension injury of the thumb, inflammatory rheumatological disorders, and medical conditions that cause swelling or fluid retention such as diabetes and weight gain associated with edematous conditions like pregnancy and renal failure.
De Quervain's tenosynovitis is a very distinct and different phenomenon from carpal tunnel syndrome. The latter involves entrapment of the median nerve in the carpal tunnel. Tendons and the median nerve run through the carpal tunnel, which is located on the volar or palm side of the wrist.
17. At the evaluation with Dr. Cupo on April 13, 2000, Claimant told him that on November 6, 1999, she developed left wrist pain after hyperextending her left wrist while using the telephone at home. Claimant related that her left wrist pain resolved over the next few days, but then recurred on November 9, 2000 with swelling in the wrist. At the time of the evaluation with Dr. Cupo, Claimant had left wrist and thumb pain, but no swelling or edema. Claimant denied any right wrist or right thumb symptoms at the evaluation. Claimant complained of increased left thumb and wrist symptoms while performing activities of daily living, such as showering, brushing her hair, applying make-up, driving, lifting, and working as a service representative.
Upon examination. Dr. Cupo found, among other things, positive Finkelstein's test, no swelling of the left wrist or hand, some tenderness to palpation over the first dorsal left wrist compartment, decreased range of motion and presence of pain at the thumb with grip and pinch, and no findings for carpal tunnel syndrome. Dr. Cupo opined that Claimant's physical findings were consistent with left de Quervain's tenosynovitis.
Although Dr. Cupo acknowledged that de Quervain's tenosynovitis could be caused by cumulative trauma, based on the history provided by Claimant that her symptoms began after the telephone incident at home, Dr. Cupo opined that in Claimant's case, her left de Quervain's tenosynovitis was caused by the acute hyperextension injury to her left thumb and wrist while using the telephone at home.
18. On June 8, 2001, Claimant saw Dr. Bruce Hector for an independent medical evaluation. According to Dr. Hector, Claimant reported that she had symptoms of throbbing fingers and swelling in the hands a few days before November 6, 1999. Claimant also reported, according to Dr. Hector, that she sustained an acute hyperextension injury to the left wrist in "October of 1999" when she was using the telephone and had to manually place her wrist back into the neutral position. A week after this episode, Claimant stated that she began to experience a pinching sensation in the left thumb and pain that would radiate along the radial aspect of the wrist into the distal forearm. Claimant further related to Dr. Hector that she had gained weight during the period immediately prior to the onset of her left wrist symptoms.
Claimant told Dr. Hector that since undergoing treatment, she had experience an 80% resolution of her symptoms from de Quervain's tenosynovitis. Claimant told Dr. Hector that her symptoms were now limited to the left thumb only with periodic pinching sensation and infrequent radiation to the distal foreman .
After an examination, Dr. Hector determined that Claimant's Finkelstein's test was negative. Other clinical tests performed by Dr. Hector at the evaluation were suggestive of or consistent with median nerve entrapment, i.e., carpal tunnel syndrome, as well as, ulnar nerve entrapment at the elbow.
According to Dr. Hector's review of Claimant's medical records, Claimant weighed 177 pounds w
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