Tuesday, 17 June 2014

WhatsAppitis ?? What do you know about this ??


A 34-year-old emergency medicine                            
physician, 27 weeks pregnant,
presented with bilateral wrist pain
with sudden onset upon waking up

 She had no history
of trauma and had not engaged in
any excessive physical activity in the
previous days. Hands examination
revealed discomfort upon bilateral
palpation of the radial styloid and
mobilisation of the thumb. Physical
examination was negative for Phalen's
sign and Tinel's sign but positive
for Finkelstein's sign. Because of
the patient's pregnancy, x-rays were
not taken to rule out rhizarthrosis.
The diagnosis was bilateral extensor
pollicis longus tendinitis of the thumb.

The patient was on duty on Dec 24
(Christmas Eve), and the following day,
she responded to messages that had
been sent to her on her smartphone
via WhatsApp instant messaging
service. She held her mobile phone,
that weighed 130 g, for at least 6 h.
During this time she made continuous
movements with both thumbs to send

The diagnosis for the bilateral wrist
pain was WhatsAppitis. The treatment
consisted of non-steroidal antiinflammatory
drugs and complete
abstinence from using the phone
to send messages. Because of her
pregnancy, the patient only took
acetaminophen (1 g every 8 h for
3 days) with partial improvement, and
did not completely abstain from using
her phone, with exchange of new
messages on Dec 31 (New Year's Eve).

A so-called Nintendinitis was first
described in 1990,1 and since then
several injuries associated with video
games and new technologies have
been reported.2,3 Initially reported in
children, such cases are now seen in
adults. Tenosynovitis caused by texting
with mobile phones could well be an
emerging disease. Physicians need to be
mindful of these new disorders.

I declare that I have no competing interests.

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