Clinical and Ultrasound Features of Constrained Extensor Carpi Ulnaris Tendinopathy; Stenosing Tendovaginitis and Tendinosis in the Patients with Dorsal Ulnar-sided Wrist Pain

Junko Sato1, *, Yoshinori Ishii1, Hideo Noguchi1, Ikuko Takahashi1
1 Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama 361-0037, Japan

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© 2023 Sato et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama 361-0037, Japan;
Tel: 011-81-485-55-3519; Fax: 011-81-485-55-3520; E-mail:



To investigate the ultrasound and clinical features of constrained Extensor Carpi Ulnaris (ECU) tendinopathy to have a better understanding of ulnar-sided wrist pain.


The cause of dorsal ulnar-sided wrist pain tends to be vague and unclear due to too many closely adjacent small structures. Constrained ECU tendinopathy has been scarcely reported, and it is unknown how often this disorder is found among the wrists with such pain.


The purpose of this study was to compare the patients’ backgrounds between two groups; the wrists diagnosed as constrained ECU tendinopathy by using ultrasonography and the other dorsal ulnar-sided painful wrists.


Totally 103 wrists from 103 consecutive patients (45 men and 58 women; age 13-78 years; mean age 43.7 years) who visited our clinic with dorsal ulnar-sided wrist pain were examined by physical test and sonography. We separated them into two groups of wrists with or without constrained ECU tendinopathy and compared patients’ data between them.


Twenty-six wrists (25%) were diagnosed as constrained ECU tendinopathy mainly located in the distal area than the ulnar osseous groove. All of them were ECU tendovaginitis and 15 wrists were concomitant with ECU tendinosis. The results of the comparison showed the proportion of females was higher, that of patients who have relevant sports activity was lower, and patients’ age was slightly higher in the wrists with constrained ECU tendinopathy (p<0.05).


Among the wrists with dorsal ulnar-sided pain, constrained ECU tendinopathy occurs more frequently in middle-aged to elderly women and less frequently in sports-related patients, These tendencies are similar to other stenosing synovitis such as de Quervain`s disease.


For vague dorsal ulnar-sided wrist pain, physician should be aware of these tendencies and the advantage of ultrasonography given that constrained ECU tendinopathy might be frequently encountered more than expected.

Keywords: Etensor carpi ulnaris, Sixth dorsal extensor compartment, Dorsal ulnar-sided wrist pain, Tendinosis, Stenosing tenosynovitis, Ultrasonography.