Ultrasound-guided percutaneous injection to treat de Quervain’s disease using three different techniques: a randomized controlled trial

Davide Orlandi, Angelo Corazza, Emanuele Fabbro, Giulio Ferrero, Giuseppe Sabino, Giovanni Serafini, Enzo Silvestri, Luca Maria Sconfienza

Research output: Contribution to journalArticlepeer-review

Abstract

Methods: We prospectively treated 75 consecutive patients (51 females, 24 males, mean age±standard deviation = 45.3 ± 9.8 years) with DQD. Patients’ features (hand dominance, intraretinaculum septum, accessory tendons) were recorded. Visual analogue scale (VAS), reduced disability (quickDASH) score, and retinaculum thickness were evaluated at baseline and after one (excluding retinaculum thickness), three, and six months. Patients were randomized into three groups of 25 patients each treated under ultrasound guidance: Group A (1 ml methylprednisolone acetate; mean baseline thickness = 1.6 mm; mean baseline VAS = 6; mean baseline quickDASH = 55); Group B (1 ml methylprednisolone acetate +15-day delayed 2 ml saline 0.9 %; 1.4; 6; 56); Group C (1 ml methylprednisolone acetate +15-day delayed 2 ml low molecular weight hyaluronic acid; 1.7; 6; 55).

Purpose: To compare the six-month outcome of three different ultrasound-guided treatments for de Quervain’s disease (DQD).

Results: After one month results were: Group A mean VAS = 2; mean quickDASH = 23; Group B 2; 22; Group C 2; 21. After three months results were: Group A retinaculum thickness = 0.7 mm; 3; 27); Group B 0.8 mm; 1; 25; Group C 0.5 mm; 1; 23. After six months results were: Group A 1.5 mm; 3; 51; Group B 1 mm; 2; 51; Group C 0.7 mm; 1; 26 (P <0.001 for all vs. baseline). Patients’ age, sex, hand dominance, presence of subcompartment dividing septum, and supernumerary tendons had no influence on outcome (P ≥ 0.177).

Conclusion: Addition of hyaluronic acid to ultrasound-guided injections of steroids to treat DQD seems to improve the outcome and to reduce the recurrence rate.

Key Points: • Ultrasound guidance allows for safe injection procedures to treat de Quervains’ disease

• Steroid injections allow prompt recovery in de Quervain’s disease with short-term recurrence

• Addition of hyaluronic acid allows recurrence rate reduction compared to simple steroid injections

Original languageEnglish
Pages (from-to)1512-1519
Number of pages8
JournalEuropean Radiology
Volume25
Issue number5
DOIs
Publication statusPublished - May 1 2015

Keywords

  • de Quervain’s tenosynovitis
  • Hyaluronic acid
  • Injection
  • Ultrasound guidance
  • Viscoinduction
  • Viscosupplementation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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