Ortho Dx: Thumb pain with repeated lifting

 

A 57-year-old woman presents with a 3-week history of thumb pain. She started babysitting her 1-year-old granddaughter a month previously and lifting the toddler seems to aggravate the pain. The woman has tried oral nonsteroidal anti-inflammatory drugs, with minimal relief. Examination reveals negative first carpometacarpal grind test, no active triggering at the A1 pulley, and positive ...