Ultrasound-Guided Corticosteroid Injection for the Treatment of de Quervain’s Tenosynovitis (original) (raw)
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Impact of Corticosteroid Injection on The de Quervain’s Tenosynovitis
KYAMC Journal
Background: de Quervain’s tenosynovitis may be caused by thickened extensor retinaculum which holds the tendon in position in wrist. There are both operative and non-operative treatments for the condition. Corticosteroid injection is a very good conservative treatment option. Objective: To see the outcome of corticosteroid Injection in the de Quervain’s Tenosynovitis. Materials and Methods: This was prospective interventional study conducted at the outpatient department of Kurmitola General Hospital during the period from January 2018 to December 2019. Total 71 patients with de Quervain’s tenosynovitis were analyzed. Secondary outcomes were measured by Visual Analogue Scale (VAS) and Quick Disabilities of Arm, Shoulder and Hand (DASH) score. Results: Among the 71 affected hands, 11 (16.22%) patients had recurred. Sixty (83.78%) patients had no positive sign or symptom after 6 months of follow-up. Average VAS before injection was 8.27±1.23. Post injection VAS was 0.82±1.49 at 1 month...
Results of injection corticosteroids in treatment of De Quervain's Tenosynovitis
JPMA. The Journal of the Pakistan Medical Association, 2014
De Quervain's tenosynovitis is defined as stenosing tenosynovitis of the synovial sheath of tendons of abductor polices longus and extensor pollicis brevis in the first compartment of wrist due to repetitive use. To assess the results of injecting corticosteroids injections for De Quervain's tenosynovitis. 80 patients with disease were included in this study. All had a mean of 5.87 weeks of treatment of the condition with NSAIDs and had shown no response. Using Visual analogue scale the severity of tenderness on first dorsal compartment and pain felt on Finkelstein test was recorded. A mixture of 1 ml (40mg) of methylprednisolone acetate and 1 ml of 2% lignocaine hydrochloride was injected in first dorsal compartment of involved wrist. Patients were followed for 28 weeks on monthly basis. Outcome measure was reduction in pain and tenderness on the radial side of wrist and negative Finkelstein test subsequent to injection. 65% patients after 1st injection were symptoms free a...
Outcome Of Intra-Sheath Steroid Injection For De Quervain’s Tenosynovitis
2014
Introduction: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain along with impaired function of the wrist and hand. Various modalities of treatment include plinting, local corticosteroid injection and surgical decompression. In this prospective study the effectiveness of local corticosteroid injections for de Quervain's tenosynovitis was assessed. MATERIAL & METHODS: Sixty patients with de Quervain’s tenosynovitis with no response for oral and local NSAIDs were included. The severity of tenderness on first dorsal compartment and pain felt on Finkelstein test was recorded on Visual Analogue Scale. A mixture of 1 ml of methlyprednisolone and 1 ml of 1% lidocaine hydrochloride was injected into the first dorsal compartment of the involved wrist. Patients were followed for clinical assessment fortnightly for 6 months. Outcome was accessed by reduction of pain according to visual analogue scale. RESULTS: ...
Journal of University Medical & Dental College, 2021
BACKGROUND & OBJECTIVE: De Quervain's tenosynovitis is tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons, occurs due to chronic overuse of the wrist and hand. To compare effectiveness of steroid injection with conservative management of De Quervains’s tenosynovitis. METHODOLOGY: Randomized prospective study was conducted at the various private orthopedic clinic across Rawalpindi district, along with collaboration of community medicine department, Rawal Institute of health sciences, Islamabad. The study population was divided into two groups, i.e., group A and group B. Group A was given inj. corticosteroid and group B was given conservative management. The severity of pain (Visual analogue scale) and Finkelstein test were recorded on baseline and after 3 weeks follow up. RESULTS: Our study included 96 diagnosed cases of de Quervains tenosynovitis on a positive Finkelstein test; 48 were given corticosteroid injection and 48 were conservatively trea...
dequervain s disease , 2020
De-quervain's disease is a term used for stenosing tenosynovitis of the dorsal compartment of the wrist. This produces chronic pain and debilitation. We report two cases of such illness with failed oral steroid therapy. Ultrasound guided injection of a combination of steroid and local anaesthetic was very effective in decreasing pain and improving movements in both the patients. There were no untoward side effects. We theorize that ultrasound detects the precise location of injection which may contribute to effective analgesia in such refractory cases.
Medicine international, 2023
De Quervain's tenosynovitis (DQt) is a painful stenosing tenosynovitis of the first dorsal compartment of the wrist, which may be refractory to conservative treatments. The present study aimed to evaluate the efficacy of ultrasound (US)-guided platelet-rich plasma (PrP) injection for the management of DQt. For this purpose, from January, 2020 to February, 2021, 12 patients with DQt who received the US-guided PrP injection were studied prospectively. all patients were evaluated clinically for pain intensity using the visual analog scale and sonographically prior to treatment. the patients were followed-up at 1 and 3 months after the procedure to evaluate the efficacy of the treatment. In total, 12 hands of 12 female patients with DQt were analyzed in the present study. the post-treatment clinical evaluation revealed complete recovery in 4 (33.3%) of the patients, and 6 (50%) of them had recovered and returned to their daily activities. The sonographic evaluation revealed a significant reduction in the mean retinaculum thickness from 1.84 to 1.069 mm, and mean tendon sheath effusion from 2.06 to 1.25 mm, with only 58% of the cases having tendon sheath effusion at 3 months post-treatment. on the whole, the findings of the present study demonstrate that US-guided PrP injection with needle tenotomy can be used as an alternative non-surgical therapy for patients who do not respond to conventional conservative treatments, particularly in cases with sub-compartmentalization. the use of US may play a crucial role in the treatment of DQt, as improved clinical outcomes can be obtained with US-guided injections, particularly in cases with sub-compartmentalization.
Effective Conservative Treatments for de Quervain ’ s Tenosynovitis : A Retrospective Outcome Study
2018
Study Design: Retrospective chart review. Introduction: De Quervain’s tenosynovitis is a repetitive stress disorder occurring at the first dorsal compartment of the wrist at the radial styloid and is commonly treated by hand therapists. 1-3 Conservative treatments include activity modification, modalities, orthotics, and manual therapy. 4-7 The literature is unclear regarding best practice for treating de Quervain’s tenosynovitis with conservative methods. 5,8,9 Purpose of the study: The purpose of this study was to identify which treatment or treatment combinations was most effective to reduce pain and improve functional outcomes for patients with de Quervain’s tenosynovitis. Methods: A retrospective chart review was conducted with 42 patients seen in outpatient therapy. Patient pain was measured using the Numeric Pain Rating Scale (NPRS) and the QuickDASH was utilized to assess functional outcomes. 10,11 Results: Both iontophoresis with dexamethasone and therapeutic pulsed (20% or...
Musculoskeletal Surgery, 2019
Introduction De Quervain described tenosynovitis of first dorsal compartment more than 120 years ago. Women, particularly of 4th-5th decades, are at more risk of developing disease. Steroid injection has been described as first line of management over many decades, but it is associated with some significant complications like depigmentation of skin, atrophy of subcutaneous tissue, suppurative tenosynovitis and even tendon rupture. Animal studies have also reported increased risk of peritendinous adhesions with steroid injection. Materials and methods We prospectively managed 46 cases of De Quervain's tenosynovitis with longitudinal incision at tertiary care hospital from 2014 to 2016. There were totally 40 patients with 9 males and 31 females between age group of 28 and 62 years. All patients were evaluated using DASH and VAS scores preoperatively and post-operatively. Results The mean preoperative DASH score was 42.26 which reduced to 5.37 post-operatively. The mean preoperative VAS score was 7.30 which reduced to 2.33 post-operatively. Intraoperatively, we found peritendinous adhesions in 8 patients and ganglion arising from first dorsal compartment in one patient. Post-operatively, we found hypertrophic scar in 3 patients and persistent numbness to first dorsal web space due to injury to superficial radial nerve in 2 patients. Six patients had recurrent symptoms and required revision surgery. Conclusion Surgical release of De Quervain's tenosynovitis remains the gold standard treatment, and longitudinal incision offers advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions and less risk of palmar subluxation of tendons.