A bursa within the first extensor compartment alongside the abductor pollicis longus tendon, reducing friction as the APL passes through the narrow fibro-osseous tunnel under the extensor retinaculum at the radial wrist. De Quervain tenosynovitis involves this bursa alongside the EPB tendon.
The APL wrist bursa is inflamed in de Quervain tenosynovitis alongside the EPB tendon sheath, both running in the first extensor compartment. Ultrasound demonstrates fluid in the first compartment sheath and associated bursal swelling. The Finkelstein test (ulnar deviation with thumb enclosed in fist) reproduces pain from bursal and tendinous compression under the retinaculum. First compartment release decompresses both the APL and EPB bursae simultaneously.
Combined APL and EPB bursal and tendon sheath inflammation in the first extensor compartment producing radial wrist pain and thumb base tenderness, confirmed by positive Finkelstein test and treated by retinaculum release.
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