Ultrasound-guided methotrexate injection for De Quervain disease of the wrist: what lies beyond the horizon?

Allam, Abdallah El-Sayed; Alashkar, Doaa Shawky; Negm, AA; Eltawab, Basma Aly; Wu, Wei‐Ting; Chang, Ke‐Vin

doi:10.2147/jpr.s143256

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…13 In the present study, the authors demonstrated that ultrasound-guided steroid injections conferred significantly better outcomes over manual injection techniques, both in terms of injection accuracy as assessed by anatomical studies, 14,21,22 and clinical cure rates. 26,[39][40][41][42][43][44][45] In a study directly comparing both approaches, a 91 percent clinical success rate, defined as the avoidance of surgery, was reported for the ultrasound-guided injection group and a 59 percent success rate was reported for the manual injection group. 26 In cadaveric studies assessing injection accuracies, the accuracy of manual injection techniques targeting the first dorsal compartment ranged from 40 to 100 percent, whereas that of ultrasound-guided injections ranged from 90 to 100 percent.…”

Section: Discussionmentioning

confidence: 99%

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Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Abi‐Rafeh

Jaberi

Kazan

et al. 2022

Plastic &Amp; Reconstructive Surgery

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De Quervain stenosing tenosynovitis is characterized by swelling and thickening of the extensor retinaculum covering the first dorsal compartment, through which the abductor pollicis longus and extensor pollicis brevis tendons pass. [1][2][3] There exist notable variations in first dorsal compartment anatomy as described according to the Hiranuma classification. 4,5 Presenting patients report pain, swelling, and discomfort over the

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Section: Discussionmentioning

confidence: 99%

“…A comprehensive synthesis of the therapeutic applications of ultrasound was compiled and outcomes compared to the present standard of care, to further guide plastic surgeons in the evidence-based management of this condition. 1–61…”

mentioning

confidence: 99%

Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Abi‐Rafeh

Jaberi

Kazan

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…Ibuprofen (Advil, Motrin) and naproxen are two examples used for pain relief. In severe cases, oralSteroids or local anaesthetic injections into the tendon sheath are quite effectively used 20 . Previous studies have identified the prevalence of De Quervain's tenosynovitis among different occupations and its association with thumb pain.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of DeQuervain’s Tenosynovitis among Clinical Physical Therapists in Islamabad: A cross-sectional study

Irfan¹,

Butt²,

Ahmed³

et al. 2023

PJMHS

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Aims: To determine the prevalence of De Quervain’s tenosynovitis among clinical physical therapists in Islamabad. Study design: A descriptive cross-sectional study Place and duration: We conducted this study among clinical physical therapists working in hospitals and clinics of Rawalpindi and Islamabad from Feb 2022 to Aug 2022. Methods: We included 288 clinical physical therapists that were selected through non-probability quota sampling. Both male and female clinical physical therapists with ages ranging from 25 to 50 yrs having thumb pain, with one year of clinical experience who worked for 4 to 8 hours per day at least 4 days a week were included in the study. The De Quervain tenosynovitis was diagnosed in participants having tenderness at the base of the thumb and a positive Finkelstein test. A positive Finkelstein sign indicates pain over the region of the abductor pollicis and extensor pollicis tendon. The data were collected and statistically analyzed using SPSS version 26. Results were shown in the form of frequency tables and graphs. Results: Out of 288 participants, 77(26.73%) had tenderness at the base of the thumb and 77(26.74%) clinician physical therapists had positive Finkelstein test. This indicates that 26.73% had De Quervain’s Tenosynovitis. Out of them, 31.94% of cases were males and 21.51% were females. Out of these 77 therapists, 4(5.2%) therapists suffered from mild pain, 61 (79.2%) physical therapists experienced moderate pain while 12(15.6%) therapists with positive cases had severe thumb pain. Conclusions: The study concluded that there was a prevalence of De Quervain’s tenosynovitis among clinical physiotherapists experiencing thumb pain. Key words: De Quervain’s tenosynovitis, Physical Therapists, Finkelstein’s test, Thumb pain

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Conservative Management of de Quervain Stenosing Tenosynovitis: Review and Presentation of Treatment Algorithm

Abi‐Rafeh

Kazan

Safran

et al. 2020

Plastic &Amp; Reconstructive Surgery

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Background: Nonsurgical management of de Quervain disease relies mainly on the use of oral nonsteroidal antiinflammatory drug administration, splint therapy, and corticosteroid injections. Although the latter is most effective, with documented success rates of 61 to 83 percent, there exists no clear consensus pertaining to conservative treatment protocols conferring the best outcomes. This article reports on all present conservative treatment modalities in use for the management of de Quervain disease and highlights specific treatment- and patient-related factors associated with the best outcomes. Methods: A systematic search was performed using the PubMed database using appropriate search terms; two independent reviewers evaluated retrieved articles using strict inclusion and exclusion criteria. Results: A total of 66 articles met the inclusion criteria for review, consisting of 22 articles reporting on outcomes following a single conservative treatment modality, eight articles reporting on combined treatment approaches, 13 articles directly comparing different conservative treatment regimens, and 23 case reports. Conclusions: A multimodal approach using splint therapy and corticosteroid injections appears to be more beneficial than either used in isolation. Although there exists some evidence showing that multipoint injection techniques and multiple injections before surgical referral may provide benefit over a single point injection technique and a single injection before surgery, corticosteroid use is not benign and should thus be performed with caution. Ultrasound was proven valuable in the visualization of an intercompartmental septum, and ultrasound-guided injections were shown to both be more accurate and confer better outcomes. Several prior and concurrent medical conditions may affect conservative treatment outcome. A Level I to II evidence-based treatment protocol is recommended for the optimal nonsurgical management of de Quervain disease.

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Ultrasound-guided methotrexate injection for De Quervain disease of the wrist: what lies beyond the horizon?

Cited by 6 publications

References 23 publications

Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis

Prevalence of DeQuervain’s Tenosynovitis among Clinical Physical Therapists in Islamabad: A cross-sectional study

Conservative Management of de Quervain Stenosing Tenosynovitis: Review and Presentation of Treatment Algorithm

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