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04.04.2018 | Musculoskeletal

US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases

verfasst von: Franck Lapègue, Aymeric André, Etienne Pasquier Bernachot, Ezin Jocelyn Akakpo, Pierre Laumonerie, Hélène Chiavassa-Gandois, Omar Lasfar, Christophe Borel, Marine Brunet, Olivia Constans, Hubert Basselerie, Nicolas Sans, Marie Faruch-Bilfeld

Erschienen in: European Radiology | Ausgabe 9/2018

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Abstract

Purpose

To evaluate the efficacy of ultrasonography-guided percutaneous treatment of de Quervain tenosynovitis with the combination of a corticosteroid injection and release of the retinaculum of the first extensor compartment tendons with a 21-gauge needle.

Materials and methods

The first part of our study consisted of ten procedures on cadaver wrists followed by dissection to analyse the effectiveness of the retinaculum release and detect any collateral damage. The second part was a prospective clinical study of 35 procedures. Outcomes were evaluated through a 6-month clinical follow-up and telephone interview at the end of the study. The following parameters were monitored over time: pain level on a visual analogue scale, the QuickDASH and the PRWE. Patient satisfaction questionnaires were also administered.

Results

No complications were found during the cadaver study. However, the release was confirmed as ‘partial’ in all wrists. In the clinical portion of this study, significant improvement was observed in 91.4 % of cases (32/35) within 1 month and the results were stable until the end of the study; all of these patients avoided surgery. The release procedure failed in three patients who eventually required surgical treatment.

Conclusion

US-guided partial release and simultaneous corticosteroid injection for treatment of de Quervain’s disease using a 21-gauge needle is feasible in current practice, with minimal complications.

Key Points

• Ultrasound-guided treatment of de Quervain's disease is feasible with a 21G needle.

• There was notable regression of clinical signs in 91.4 % of cases.

• The procedure is very safe, no iatrogenic neurovascular or tendinous injuries occurred.

• Our procedure requires only one session and 3 days away from work.

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Titel: US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases
verfasst von: Franck Lapègue
Aymeric André
Etienne Pasquier Bernachot
Ezin Jocelyn Akakpo
Pierre Laumonerie
Hélène Chiavassa-Gandois
Omar Lasfar
Christophe Borel
Marine Brunet
Olivia Constans
Hubert Basselerie
Nicolas Sans
Marie Faruch-Bilfeld
Publikationsdatum: 04.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5387-1

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US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases