Effect of Ultrasound-guided Corticosteroid Injection Versus Palpation-guided Injection for de Quervain's Disease
De Quervain Disease
About this trial
This is an interventional treatment trial for De Quervain Disease focused on measuring De Quervain Disease, ultrasound-guided injection, intra-articular injection
Eligibility Criteria
Inclusion Criteria:
- Pain and tenderness at the radial side of the wrist.
- Positive Finkelstein sign, or pain on resistive maximal isometric contraction of extension and/or abduction of the affected thumb.
- pain intensity on a 10-point visual analog scale (VAS) for pain to ≧ 3 on active thumb abduction or extension.
- Patient agrees to receive either palpation-guided or US-guided local corticosteroid injection.
- Age ≧ 20 years old.
Exclusion Criteria:
- Presence of an absolute contraindication for corticosteroids or local anesthetics injection.
- During pregnancy.
- Severe systemic diseases with poor control.
- Prior treatment with corticosteroid injection and/or surgery at the same anatomical location in the last 6 months.
- Being unable to fill-in the follow-up forms.
Sites / Locations
- Shin Kong Wu Ho-Su Memorial Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
palpation-guided injection
US-guided injection
Injectate: a mixture of 10mg triamcinolone acetonide (10mg/1ml) and 0.3ml 1% lidocaine. For palpation-guided injection, a 2.5cm 25-gauge needle will be inserted almost horizontally between APL and EPB tendons, just distal to the radial styloid, at the site of maximum tenderness. Then the mixture of triamcinolone and lidocaine will be pushed into the common tendon sheath.
For US-guided injection, a 22 MHZ linear array probe (Esaote MyLab™ClassC, Italy) will be used for guidance of injection via a transverse scan, in-plane approach. After sterilization, the probe will be placed at the radial styloid with maximal swelling or tenderness. Then a 2.5 cm 25-gauge needle will be placed into the tendon sheath via transverse scan, in-the-plane approach, and the injectate will be pushed into the tendon sheath. Care will be taken avoiding injury of vessels and the superficial branch of radial nerve during the injection.