COMPARISON OF EFFICACY OF INJECTABLE STEROIDS VERSUS CONSERVATIVE MANAGEMENT FOR DE QUERVAINS’S TENOSYNOVITIS

Nasim Ilyas Nasim Ilyas,Rajesh Kumar Panjwani Rajesh Kumar Panjwani,Fouzia Hanif Fouzia Hanif,Abdul Hameed Abdul Hameed,Asma Abdul Qadeer Asma Abdul Qadeer,Sheikh Kashif Rahim Sheikh Kashif Rahim

doi:10.37723/jumdc.v12i3.555

Nasim Ilyas Nasim Ilyas, Rajesh Kumar Panjwani Rajesh Kumar Panjwani + Show 4 more

Open Access

https://doi.org/10.37723/jumdc.v12i3.555

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Abstract

BACKGROUND & OBJECTIVE: De Quervain's tenosynovitis is tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons, occurs due to chronic overuse of the wrist and hand. To compare effectiveness of steroid injection with conservative management of De Quervains’s tenosynovitis. METHODOLOGY: Randomized prospective study was conducted at the various private orthopedic clinic across Rawalpindi district, along with collaboration of community medicine department, Rawal Institute of health sciences, Islamabad. The study population was divided into two groups, i.e., group A and group B. Group A was given inj. corticosteroid and group B was given conservative management. The severity of pain (Visual analogue scale) and Finkelstein test were recorded on baseline and after 3 weeks follow up. RESULTS: Our study included 96 diagnosed cases of de Quervains tenosynovitis on a positive Finkelstein test; 48 were given corticosteroid injection and 48 were conservatively treated. The mean age in corticosteroid’s injection group was 34.76+6.95 years whereas the mean age in conservative management group was 31.7+8.91 years. Post-intervention 13, 29 patients had a positive Finkelstein test in corticosteroid and conservative groups respectively. Although the difference in pre intervention pain score between the two groups was not statistically significant but significantly lesser pain scores in the corticosteroid group; (p= 0.00). CONCLUSION: Steroid injection produced better results in terms of relief in pain and negative Finkelstein test as compared to conservative treatment.

Highlights

De Quervain's tenosynovitis (DQT) is known as De Quervain’s tendinosis, tendonitis, disease, or syndrome caused by impaired gliding of the tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles[1].These musculotendinous units control the position and orientation, force application and joint stability of the thumb
The impaired gliding is believed to be as a result of thickening of the extensor retinaculum at the first dorsal compartment of the wrist, with subsequent narrowing at the fibro-osseous canal [2]
Keeping in mind the importance of hand use in our daily life and ailment of DQT, its associated effects, we planned to address this issue in our local setting as there is no previous research on this topic from our settings[7]

Summary

Introduction

De Quervain's tenosynovitis (DQT) is known as De Quervain’s tendinosis, tendonitis, disease, or syndrome caused by impaired gliding of the tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles[1].These musculotendinous units control the position and orientation, force application and joint stability of the thumb. Comparison of efficacy of injectable steroids versus conservative management for De Quervains’s tenosynovitis. To compare the efficacy of steroid injection with conservative management in the treatment of DQT. METHODOLOGY: Randomized prospective study, (Line listing was done, patients with even, odd number serial numbers were selected among group A and B respectively) was done at private orthopedic clinics across Rawalpindi district, in collaboration with community medicine department, RIHS, Islamabad.

Results

Conclusion