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. 2015 Jun;40(6):1161-5.
doi: 10.1016/j.jhsa.2014.12.027. Epub 2015 Apr 30.

De Quervain tendinopathy: survivorship and prognostic indicators of recurrence following a single corticosteroid injection

Brandon E Earp  1 , Carin H Han  2 , W Emerson Floyd  2 , Tamara D Rozental  2 , Philip E Blazar  2
Affiliations

De Quervain tendinopathy: survivorship and prognostic indicators of recurrence following a single corticosteroid injection

Brandon E Earp et al. J Hand Surg Am. 2015 Jun.

Abstract

Purpose: To determine short- and long-term success rates of a single corticosteroid injection for de Quervain tendinopathy while identifying prognostic indicators for symptom recurrence and repeat intervention.

Methods: Fifty consecutive patients with de Quervain tendinopathy treated with corticosteroid injections (lidocaine plus triamcinolone acetonide or dexamethasone) were prospectively enrolled. Patients with inflammatory arthritis, carpometacarpal osteoarthritis, or a previous distal radius fracture affecting the symptomatic wrist were excluded. Demographic data and information on existing comorbidities were recorded. Patients were seen in clinic at 6 weeks after injection and contacted at 3, 6, 9, and 12 months following injection to determine symptom recurrence and further intervention. Medical records were also reviewed for this purpose. Kaplan-Meier survival analysis and Cox regression modeling were used to estimate recurrence rates and identify predictors of symptom recurrence and repeat intervention.

Results: Fifty wrists in 50 patients (average age, 49 y) were included. One patient was lost to follow-up. Eighty-two percent of patients had resolved symptoms 6 weeks after a steroid injection. Twenty-four patients had a recurrence of symptoms at a median of 84 days after the injection. Eleven patients underwent additional intervention (7 surgical releases and 4 repeat injections) at a median of 129 days (range, 42-365) after the injection. Estimated freedom from symptom recurrence was 52% at 6 and 12 months. Estimated freedom from repeat intervention was 81% at 6 months and 77% at 12 months. Two of 3 patients with a history of trigger finger required subsequent de Quervain surgery.

Conclusions: We demonstrated that a single cortisone injection was effective in alleviating symptoms of de Quervain tendinopathy in 82% of patients and that over half remained symptom-free for at least 12 months. All patients with recurring symptoms developed them within the first 6 months.

Type of study/level of evidence: Prognostic IV.

Keywords: de Quervain; injection; steroid; survivorship.

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