Abstract: Background: Open surgical release of the 1st extensor compartment is the gold standard of treatment for De Quervain’s tenosynovitis, with reliable symptomatic relief. The purpose of this retrospective study is to determine the effectiveness of corticosteroid injections for non-surgical treatment of this condition, and the incidence of side effects of this procedure.
Methods: A retrospective study was done in evaluating the use of CPT code 20550 (Injection(s); tendon sheath, ligament) used as intervention for the diagnosis of M65.4 (Radial styloid tenosynovitis [de Quervain]). Success of the intervention was defined as clinical resolution of pain to the extent that the patient did not seek further intervention after 1 or 2 injections. Failure was defined as a subsequent surgical release or need for a third injection. Side effects of the procedure were documented on the basis of documentation in subsequent visits as per the records.
Results: The treatment outcome of 55 limbs from 45 patients was studied. Of the 55 limbs, 80% (44/55) experienced treatment success within 2 injections, and 61.82% (34/55) experienced success after 1 injection. Predominantly 3 side effects were documented which were 1. Whitening of the skin at site of injection 14.55% (8/55) 2. Transient increase in pain which responded well to analgesics 10.91% (6/55) 3. Numbness over the anatomical snuffbox persisting > 1 day 1.82% (1/55).
Conclusions: This study indicates that corticosteroid injections are a useful and safe treatment for de Quervain’s tenosynovitis, leading to treatment success 80% of the time within 2 injections. This study also documents possible side effects of this procedure.
