DeQuervain's Tenosynovitis
Conditions
Keywords
De Quervain tenosynovitis, tendinopathy, corticosteroid injection, quasi-experimental study; wrist, surgical release, visual analog scale
Brief summary
This quasi-experimental study compared pain outcomes following local corticosteroid injection (CSI) versus open surgical release in 100 patients with clinically confirmed De Quervain tenosynovitis unresponsive to conservative management. Patients were allocated to treatment based on clinician judgment and patient preference. Pain was assessed using the Visual Analog Scale (VAS) at baseline, one month, and six months post-intervention. The study was conducted at a single tertiary care centre in Rawalpindi, Pakistan between March 2023 and April 2025.
Detailed description
De Quervain tenosynovitis is a stenosing tendinopathy of the first dorsal extensor compartment of the wrist, causing radial-sided wrist pain. One hundred patients were enrolled and allocated to either corticosteroid injection (CSI; n=49) or open surgical release (n=51). The CSI protocol consisted of triamcinolone acetonide (40mg/mL, 1mL) combined with 1% lidocaine (1mL) injected into the first dorsal compartment under aseptic conditions. Surgical release involved longitudinal decompression of the fibro-osseous sheath overlying the APL and EPB tendons. The primary outcome was VAS pain score at baseline, one month, and six months. Statistical analysis included independent t-tests and linear mixed-effects modeling.
Interventions
DRUGTriamcinolone acetonide with lidocaine
Triamcinolone acetonide 40mg/mL (1mL) + 1% lidocaine (1mL) - single injection
PROCEDUREOpen surgical release of first dorsal extensor compartment
Longitudinal decompression of the fibro-osseous sheath overlying APL and EPB tendons
Sponsors
Rawalpindi Teaching Hospital, District Headquarter Hospital, Rawalpindi
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
VAS assessments at follow-up were performed by a trained assessor blinded to treatment allocation.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of De Quervain tenosynovitis confirmed by positive Finkelstein test * Age 18-70 years * Pain sufficiently severe to impair activities of daily living * Failure to respond to at least 4 weeks of conservative management
Exclusion criteria
* Concurrent inflammatory arthropathy (rheumatoid arthritis or gout) * History of prior wrist injury * Previous surgical or injection treatment for De Quervain tenosynovitis * Coexisting upper limb pathology (rotator cuff pathology, epicondylitis, or carpal tunnel syndrome)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity - Visual Analog Scale (VAS) | Time Frame: Baseline, 1 month, and 6 months post-intervention | Pain scored on a 0-10 VAS scale where 0 = no pain and 10 = worst imaginable pain, assessed by a blinded assessor |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adverse events | Throughout 6-month follow-up period | Any complications or adverse events recorded in either treatment group |
Countries
Pakistan
Contacts
STUDY_CHAIRSaad Riaz, FCPS Orthopedic Surgery
Rawalpindi Teaching Hospital.
Outcome results
None listed