An intraarticular injection to the elbow joint completely relieves pain in stenosing tenosynovitis of the wrist

Abstract

Stenosing tenosynovitis of the first dorsal compartment of the wrist, de Quervain’s disease causes radial wrist pain and disability. Clinically, corticosteroids are most commonly used to treat de Quervain's disease. The injection of triamcinolone into the sheath of both the extensor pollicis brevis and abductor pollicis longus tendon is known to successfully relieve the symptoms of de Quervain’s disease. However, depigmentation of the skin and spontaneous rupture of extensor tendons have been frequently reported as side effects of injection of intra-sheath injection of triamcinolone. To bypass undesirous complications of triamcinolone for the treatment of de Quervain’s disease, we conducted an intra-articular injection of it into the elbow joint instead of an intra-sheath injection to the wrist. This retrospective study examines the results of 54 outpatients who presented with de Quervain’s disease from October 2018 through September 2021 and were treated with a combination of triamcinolone/ lidocaine injection. After single injection of triamcinolone, patients had a considerable pain relief with a dose-dependent manner and experienced an easier wrist mobility than prior to the treatment. With two times of injections, pain relief and movement flexibility were more consolidated. Adverse complications caused by the intra-articular triamcinolone were observed in none. These results indicate that the intra-articular triamcinolone in the elbow joint can provide an acceptable treatment option for de Quervain’s disease.