Ultrasound-guided injection of triamcinolone and bupivacaine in the management of De Quervain's disease
- Resource Type
- Authors
- Surabhi Choudhary; Kanagaratnam Jeyapalan
- Source
- Skeletal radiology. 38(11)
- Subject
- Adult
Male
Steroid injection
medicine.medical_specialty
Triamcinolone acetonide
medicine.drug_class
Anti-Inflammatory Agents
Therapeutics
Triamcinolone
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Anesthetics, Local
Ultrasonography, Interventional
Aged
Injections, Intraventricular
Retrospective Studies
Bupivacaine
business.industry
Local anesthetic
Ultrasound
Middle Aged
Ultrasound guided
Surgery
De Quervain Disease
Drug Therapy, Combination
Female
Ultrasonography
business
Combination method
medicine.drug
- Language
- ISSN
- 1432-2161
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.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.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.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.