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Ultrasound-guided Injections for de Quervain's Tenosynovitis
Journal article   Open access   Peer reviewed

Ultrasound-guided Injections for de Quervain's Tenosynovitis

James D. McDermott, Asif M. Ilyas, Levon N. Nazarian and Charles F. Leinberry
Clinical orthopaedics and related research, v 470(7), pp 1925-1931
01 Jul 2012
DOI: https://doi.org/10.1007/s11999-012-2369-5
PMID: 22552767
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1007/s11999-012-2369-5View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology Surgery
Nonsurgical management of de Quervain's tenosynovitis often includes corticosteroid injections. If the injection does not enter the compartment, or all subcompartments, response to the injection is variable. To ensure proper location of injections we evaluated the role of ultrasound. We determined (1) the incidence of two or more subcompartments, (2) the incidence of anatomic variations during surgical release after failed injections, and (3) the relief of pain after ultrasound-guided injections. A prospective series of 40 consecutive patients (42 wrists) diagnosed with de Quervain's tenosynovitis by clinical examination were referred to a radiologist for an ultrasound-guided injection. The radiologist injected the first dorsal compartment and noted any septations. Patients returned for followup where outcomes, DASH, and VAS scores were calculated. The treating surgeon was blinded to any anatomic variations. Followup was at 6 weeks and a minimum of 6 months (mean, 6 weeks, range, 3-17 months; mean, 11 months, range, 7-18 months). Four patients were lost to followup. Multiple subcompartments were noted in 22 of 42 (52%) wrists. At the 6-week followup, 36 of the 37 wrists examined in 36 patients (97%) had at least partial resolution of symptoms. Multiple subcompartments were identified in 52% of cases. At last followup, the mean DASH and VAS scores were 18.4 and 2.2, respectively. However 14% of wrists had recurrence of symptoms, all of which had subcompartments on ultrasound. No adverse effects from the injections were noted. We found ultrasound-guided injections to be useful for treatment of de Quervain's tenosynovitis. Our success with ultrasound-guided injections was slightly better than that reported in the literature and without adverse reactions. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
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