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Ultrasound-guided steroid injection for the treatment of de Quervain’s disease: an anatomy-based approach

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Abstract

Objective

To suggest different ultrasound-guided steroid injection (USI) techniques based on anatomical variations of the first extensor compartment (FEC), and to evaluate the usefulness of it, in patients with de Quervain’s disease.

Materials and methods

Twenty-eight patients who underwent USI for de Quervain’s disease were included. Anatomical variations were classified into complete sub-compartmentalization (n = 11), distal incomplete sub-compartmentalization (n = 5), and no sub-compartmentalization (n = 12) on ultrasound. Involved sub-compartments were recorded in patients with complete sub-compartmentalization. USIs were performed based on the anatomical variations: in both sub-compartments (n = 2) or only in the affected sub-compartment (n = 9) depending on the location of tenosynovitis involvement, in patients with complete sub-compartmentalization; in proximal FEC in patients with distal incomplete sub-compartmentalization (n = 5); in the common compartment in patients with no sub-compartmentalization (n = 12). Medical charts were retrospectively reviewed for evaluation of clinical outcome at follow-up visits.

Results

Twenty-three out of 28 patients were followed up with a mean period of 31.2 days after injection (6~87 days). Mean VAS was 7.96 before injection (range: 4 to 10), which was significantly reduced to 0.65 at rest and 1.57 during activity at follow-up visits (p < 0.05). Twenty-two out of 23 patients were satisfied with the results. The mean proportion of subjective pain reduction was 82.0% (median 95%).

Conclusion

Ultrasound-guided steroid injections using different injection techniques based on the anatomical variations of the FEC have shown to be beneficial in the management of de Quervain’s disease.

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Authors and Affiliations

  1. Department of Radiology, Asan Foundation, Gangneung Asan Hospital, University of Ulsan, College of Medicine, 38, Bangdong-gil, Sacheon-myeon, Gangneung-si, Gangwon-do, 25440, Republic of Korea

    Jong-Hyun Bing, Soo-Jung Choi, Seung-Moon Jung, Dae-Shick Ryu, Jae-Hong Ahn, Chae-Hoon Kang & Dong-Rock Shin

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  1. Jong-Hyun Bing
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Correspondence to Soo-Jung Choi.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Informed consent

The requirement for written informed consent was waived by the Institutional Review Board for this retrospective review.

Ethical approval

This study was approved by the institutional review board, which waived the requirement for informed patient consent.

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Bing, JH., Choi, SJ., Jung, SM. et al. Ultrasound-guided steroid injection for the treatment of de Quervain’s disease: an anatomy-based approach. Skeletal Radiol 47, 1483–1490 (2018). https://doi.org/10.1007/s00256-018-2958-9

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  • DOI: https://doi.org/10.1007/s00256-018-2958-9

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