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

ObjectiveTo 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 methodsTwenty-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.ResultsTwenty-three out of 28 patients were followed up with a mean period of 31.2days after injection (6 similar to 87days). 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%).ConclusionUltrasound-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.