The Lancet, Volume 383, Issue 9922, Page 1040, 22 March 2014 <Previous Article|Next Article>
doi:10.1016/S0140-6736(14)60519-5Cite or Link Using DOI
Copyright © 2014 Elsevier Ltd All rights reserved.
“WhatsAppitis”
Inés M Fernandez-Guerrero aEmail Address
A 34-year-old emergency medicine physician, 27 weeks pregnant, presented with bilateral wrist pain with sudden onset upon waking up one morning. 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 messages.
The diagnosis for the bilateral wrist pain was WhatsAppitis. The treatment consisted of non-steroidal anti-inflammatory 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.