Ultrasound-guided steroid injection: A scintillating dimension in managing de Quervain's tenosynovitis

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Ultrasound-guided steroid injection: A scintillating dimension in managing de Quervain's tenosynovitis

Journal Title: IP International Journal of Orthopaedic Rheumatology - Year 2018, Vol 4, Issue 1

Abstract

Introduction de Quervain39s tenosynovitis is a stenosing tenosynovitis of the first extensor compartment of the wrist and leads to wrist pain along with impaired function of the wrist and hand Local steroid injection and surgical release forms the mainstay treatment in the conservative and surgical line of treatment respectively till date This study aims to bring out the effectiveness of local steroid injection given accurately under ultrasound guidance making it comparable to surgical release in the short term period thereby emerging as an immediate and cost effective line of management Materials and Methods Twenty three patients diagnosed with de Quervains tenosynovitis were included in this study triamciniolone and 1 ml of 1 lidocaine hydrochloride was taken under aseptic precautions and was injected into the involved compartment under expert guidance with help of ultrasound imaging Clinical improvement was later evaluated by analyzing the pre procedural and post procedural DASH Disabilities of the Arm the Shoulder and the Hand score indexes comparing it to surgical release8whom did not show any relief of symptoms when conservative mode was used namely rest and analgesics and splinting in certain cases Clinically patients were assessed using DASH score based on the severity of condition before the procedure and after the procedure A mixture of 1 ml of Results 22 patients 96 were symptomfree out of the 23 patients that were included after the 1st injection at two weeks At the end 6 months 22 96 patients were symptom free and were fully satisfied with the gratifying outcome No recurrence in these patients after a 1 year of followup was recorded The one failed patient underwent surgery for release of the first extensor compartment and was symptomfree at the 2 weeks post op after assessment Adverse reaction of the steroids were incidentally seen in 223 16 of the patients which eventually subsided in 20 weeks Incidence of nerve injury infection or tendon rupture did not occur Conclusion We draw to close that selective infiltration of steroids in the common sheath of the EPB and APL under Ultrasound guidance provides an evocative improvement of pain and function in greater number of patients with de Quervain39s Syndrome thereby avoiding a possible surgeryKeyword Ultrasound guided infiltration DASH

Authors and Affiliations

Ashish Mathew, Latheesh Leo

Keywords

EP ID EP486035
DOI 10.18231/2455-6777.2018.0002
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