Results of injection corticosteroids in treatment of De Quervain's Tenosynovitis

Background: De Quervain's tenosynovitis is defined as stenosing tenosynovitis of the synovial sheath of tendons of abductor polices longus and extensor pollicis brevis in the first compartment of wrist due to repetitive use. Objective: To assess the results of injecting corticosteroids injections for De Quervain's tenosynovitis. Material and Methods: 80 patients with disease were included in this study. All had a mean of 5.87 weeks of treatment of the condition with NSAIDs and had shown no response. Using Visual analogue scale the severity of tenderness on first dorsal compartment and pain felt on Finkelstein test was recorded. A mixture of 1 ml (40mg) of methylprednisolone acetate and 1 ml of 2% lignocaine hydrochloride was injected in first dorsal compartment of involved wrist. Patients were followed for 28 weeks on monthly basis. Outcome measure was reduction in pain and tenderness on the radial side of wrist and negative Finkelstein test subsequent to injection. Results: 65% patients after 1st injection were symptoms free at two weeks, 35% patients were given second injection two weeks after the first. 80% patients at four weeks, 95% patients at six weeks and 98.75% patients were symptom free at 12th week. One patient underwent surgical release. The adverse reaction of steroid was seen in 25% of patients, which were subsided in 20 weeks. Conclusion: We conclude that two or three local steroid injections in the first dorsal compartment lead to significant improvement in patients with de Quervain's tenosynovitis.