Purpose
De Quervain's Disease
De Quervain’s disease is a painful stenosing tenosynovitis of the first dorsal compartment of the wrist,
caused by a thickening of the retinaculum.
This impairs the normal sliding of the abductor pollicis longus and the extensor pollicis brevis tendons.
The presence of an accessory tendon or a septum within the retinaculum may favour the occurrence of the disease.
Retinaculum thickening reflects chronic changes,
such as myxoid degeneration,
fibrocartilaginous metaplasia,
and mucopolysaccharide deposition.
De Quervain’s disease can be seen in 0.5% of males...
Methods and materials
Women with pregnancy-related disease were excluded
36 consecutive patients with clinical and US confirmed De Quervain’s disease
US-guided treatment (short axis approach)
Baseline and follow-up (1,3,6 months) evaluation
US measurement of first dorsal compartment retinaculum maximum thickness
Pain assessment (VAS)
Disability assessment (quickDASH)
Results
No adverse reactions occurred.
At 1-month follow-up we found: group 1,
mean thickness=0.5mm,
mean VAS=1.5,
mean quickDASH=22; group 2,0.6,1.4,23; group 3,0.5,1.2,21.
At 3-month follow-up: 0.5,1.1,21;0.6,1.2,21;0.4,1.1,21.
At 6-month follow-up: 0.8,3.4,32;0.6,2.1,26;0.5,1.0,19.
Discussion
Hyaluronic acid
Viscoelastic properties
Retinaculum stretching
Sheath lubrication
Conclusion
Injection can be used to treat De Quervain’s disease
Combined injection of mPA + HA is feasible
It is helpful to decrease symptoms recurrence at 6-month follow-up
Despite the small sample size,
ultrasound-guided intracompartment injection of metilprednisolone acetate+sodium hyaluronate seems to represent a promising approach to treat De Quervain’s disease.
References
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De Quervain’s disease: surgical or nonsurgical treatment.
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