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Skeletal Radiology

, Volume 38, Issue 11, pp 1099–1103 | Cite as

Ultrasound-guided injection of triamcinolone and bupivacaine in the management of de Quervain′s disease

  • Kanagaratnam Jeyapalan
  • Surabhi Choudhary
Technical Report

Abstract

Objective

The aim of this study was to describe the technique and usefulness of ultrasound-guided intrasynovial injection of triamcinolone and bupivacaine in treatment of de Quervain′s disease.

Materials and methods

A total of 17 patients with symptomatic De Quervain′s disease were included in this study. The procedure involved confirmation of diagnosis with ultrasound followed by guided injection of a mixture of 20 mg of triamcinolone (40 mg/ml) and 1 ml of 0.5% bupivacaine. Ultrasound guidance with a high resolution 15-Mhz footprint probe was used for injection into the first dorsal extensor compartment tendon sheath (E1). The response to ultrasound-guided injection was ascertained at the post procedure outpatient clinic appointment according to the follow-up clinic notes.

Results

There were 14 female and 3 male patients aged 29 to 74 years. Mean duration of symptoms was 8.9 months. One patient had an atypical septum in the first extensor compartment and the extensor pollicis brevis alone was involved. The mean post-injection follow-up was at 6.75 weeks. One patient was lost to follow-up. Fifteen out of 16 patients had significant symptomatic relief (93.75%). There were no immediate or delayed complications. Recurrence of symptoms was seen in 3 (20%) patients.

Conclusion

Ultrasound-guided injection of triamcinolone and bupivacaine is safe and useful in controlling symptoms of De Quervain′s disease. Correct needle placement with ultrasound guidance avoids intratendinous injection as well as local complications like fat atrophy and depigmentation.

Keywords

De Quervain′s tenosynovitis Ultrasound Steroid injection 

Notes

Acknowledgements

The authors acknowledge Dr Ravi Marudanayagam and the department of Medical Illustration, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, for their help with Figs. 6 and 7.

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Copyright information

© ISS 2009

Authors and Affiliations

  1. 1.Glenfield HospitalUniversity Hospitals of Leicester NHS TrustLeicesterUK

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