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Original Article

J Liaquat Uni Med Health Sci. 2013; 12(1): 30-33


Outcome of Corticosteroid Injection in De Quervain's Tenosynovitis

Gulzar Saeed Ahmed, Imtiaz Ahmed Tago, Asadullah Makhdoom.

Abstract
BACKGROUND: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal
compartment of the wrist. The diagnosis is made by history and physical examination. Finkelstein’s test is positive in typical cases.
OBJECTIVE: To assess the clinical effect of local corticosteroid injections for de Quervain's
tenosynovitis.
MATERIAL & METHODS: Fifty De Querven’s Tenosynovitis patients were included in the study.
All had a mean of 6 weeks of treatment of the condition with oral and local NSAIDs and had
shown no response. 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 (10mg) of triamcinolone acetonide and 1 ml of 1% lidocain hydrochloride was injected in first dorsal compartment of involved wrist. Patients were followed for clinical assessment fortnightly for 24 weeks.
Outcome measure was reduction in pain and tenderness on the radial side of wrist and negative
Finkelstein test subsequent to local triamcinolone acetonide injection.
RESULTS: Out of 50, thirty-five patients (70%) after 1st injection were symptoms free at two
weeks, fifteen patients who showed no improvement were given second injection two weeks
after the first. 42(84%) patients at four weeks, and all patients at six weeks were symptoms free
and fully satisfied with the therapy. All the 50 patients were followed for 24 weeks and no recurrence was found.
The adverse reaction of steroid was seen in 18/50 (36%) of patients, which were subsided in 20
weeks. There was no incidence of nerve injury, tendon rupture, or infection.
CONCLUSION: We conclude that one or two local steroid injections in the first dorsal compartment leads to significant improvement in patients with de Quervain's tenosynovitis.

Key words: De Quervain’s, Triamcinolon, local steroid.



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