Variations of anatomy on MRI of the first extensor compartment of the wrist and association with DeQuervain tenosynovitis

Chang, Connie Y.; Kheterpal, Arvin; Vicentini, Joao R. T.; Huang, Ambrose J.

doi:10.1007/s00256-017-2639-0

Cited by 27 publications

(15 citation statements)

References 28 publications

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“…The other side effect was local hypo pigmentation which was encountered in 4 patients. No incidence of injection into the tendon and tendon ruptured was noted in our series [24][25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 98%

Efficacy of Local Methylprednisolone Injection for Treatment of de Quervain’s Tenosynovitis

Khan¹

2021

OPROJ

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Objectives:The objective of this study was to find out the efficacy of local steroid injection for treatment of de Quervain's disease. Study design: Descriptive retrospectivePlace and duration of study: The study was conducted at department of orthopedic and spine surgery, Hayatabad medical complex Peshawar and Khyber medical centre dabgari garden Peshawar from January 2007 to December 2019. Patients and methods:We evaluated our data of patients with diagnosis of de Quervain's tenosynovitis from 2007 till 2019. Patients with complete demographic data and who received local steroid injection and had at least 3 months follow up were included in the study. The findings were analyzed for the effectiveness of local steroid injection. The response to injection was considered effective when the patient was symptom free and did not need surgery. Local injection of 80mg methylprednisole was injected into the first dorsal compartment of the wrists. The injection was repeated if first dose was not effective at 4 th or 8 th week with patients consent. The outcome was checked for relief of symptoms or otherwise at 4, 8 and 12 th weeks.Results: Complete record of 270 patients was available. Females were 238 and 32 were males in a ratio of 1:7.4.The average age was 39 years ( range 24-71). Out of these 26 patients follow up was not complete. 180 patients needed one, 49 two and 15 patients three injections. Out of 244 patients 70 (28.6%) patients did not improve and needed surgical intervention. The remaining 174 ( 71.4%) had complete relief of pain. 4 patients had hypo pigmentation of the wrist area. 28 patients had exaggerated pain for 2-3 days before the injection was effective.Conclusion: local steroid injection is safe and effective method for treatment of de Quervain tenosynovitis.

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Section: Discussionmentioning

confidence: 98%

Efficacy of Local Methylprednisolone Injection for Treatment of de Quervain’s Tenosynovitis

Khan¹

2021

OPROJ

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“…However, this suggests that a more convenient and less expensive examination method could be used. For example, ultrasound can detect some anatomical structures with similar sensitivity as MRI [14]. Ultrasound has also yielded good results on diagnosing ganglions and TFCC injuries [15] and soft tissue injuries [16].…”

Section: Discussionmentioning

confidence: 99%

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

Ratasvuori

Lindfors

Sormaala

2021

Journal of Plastic Surgery and Hand Surgery

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Magnetic resonance imaging (MRI) is a common diagnostic tool in hand surgery. However, there is limited knowledge on the kind of findings that are relevant in treatment planning. We analysed the findings and utility of arm, wrist, metacarpal, and finger MRIs taken in a tertiary hand surgery clinic of 318 consecutive images from 316 patients referred by a hand surgeon or hand surgeon resident. Ganglions (28%), findings on the extensor carpi ulnaris tendon (18%) and on the triangular fibrocartilage (18%) were the most common findings and increased with patient age; the clinical significance of these findings was minimal. The correlation between the clinical scaphoid shift test or the fovea sign test and MRI was also non-significant. Despite findings on MRI, the diagnosis remained unsolved in 76 (24%) cases. However, MRI had a role in reassuring the patient, and in 70% of the cases, further follow-up was unnecessary. This study demonstrates that the indications for wrist and hand MRI must be considered thoroughly and interpretation of the MRI report requires knowledge.

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“…Ultrasound has been shown to have only a fair positive predictive value (73%) for detecting a subcompartment, while MRI has demonstrated only moderate interreader agreement (0.733) on the presence of septations. 21,22 Clearly, the most accurate method to determine the anatomy is direct observation of the first dorsal compartment via surgical exploration, as employed in the present study. In addition, as our study was conducted on live patients rather than cadaveric specimens, in all cases we were able to examine and diagnose our subjects preoperatively, thereby providing the study with the capacity to identify septation and accurately assess its presence in patients with and without De Quervain disease.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of a Septated First Dorsal Compartment Among Patients With and Without De Quervain Tenosynovitis: An In Vivo Anatomical Study

Beutel

Doscher

Melone

2018

Hand (New York, N,Y.)

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Background: The reported prevalence of a subcompartment housing the extensor pollicis brevis (EPB) tendon within the first dorsal compartment varies widely in the literature, especially regarding the rates of occurrence between genders and among those with and without De Quervain. Based on direct intraoperative observation, we hypothesized that the prevalence of a septated compartment is far greater than previously reported, particularly in those with De Quervain disease. Methods: A prospective analysis of consecutive patients who underwent first dorsal compartment release was carried out. Patients were divided into 2 groups: those with De Quervain tenosynovitis (“De Quervain” group) and a control cohort without a primary diagnosis of De Quervain (“non–De Quervain” group). The intraoperative findings of a single compartment or a separate subcompartment were recorded. The prevalence of a septated compartment was calculated and compared between genders and both patient groups. Results: A total of 102 consecutive patients were included, with a female predominance (74.5%). Overall, 79.4% of patients had a separate subcompartment for the EPB. In the De Quervain cohort, 89.1% had 2 compartments, while 71.4% of non–De Quervain patients had a subcompartment. Men and women had a similar rate of double compartments (80% and 82.4%, respectively). Conclusions: The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients afflicted with De Quervain tenosynovitis. This higher rate of septation occurs with a similar prevalence in both men and women. Owing to its consistent presence, the dual first dorsal compartment should be regarded as an expectant anatomical component of the normal wrist.

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Variations of anatomy on MRI of the first extensor compartment of the wrist and association with DeQuervain tenosynovitis

Cited by 27 publications

References 28 publications

Efficacy of Local Methylprednisolone Injection for Treatment of de Quervain’s Tenosynovitis

Efficacy of Local Methylprednisolone Injection for Treatment of de Quervain’s Tenosynovitis

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

Prevalence of a Septated First Dorsal Compartment Among Patients With and Without De Quervain Tenosynovitis: An In Vivo Anatomical Study

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