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. 2019 Nov;14(6):741-745.
doi: 10.1177/1558944718787282. Epub 2018 Jul 12.

Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome

Joseph Marchese  1 , Kathleen Coyle  1 , Mark Cote  1 , Jennifer Moriatis Wolf  2
Affiliations

Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome

Joseph Marchese et al. Hand (N Y). 2019 Nov.

Abstract

Background: The role of corticosteroid injections in the treatment of radial tunnel syndrome (RTS) has not been evaluated in depth. The purpose of this study was to evaluate the utility of a single corticosteroid injection as a therapeutic modality for RTS. Methods: We enrolled 40 patients with a clinical diagnosis of RTS. Our primary outcome was the quick Disabilities of the Arm, Shoulder and Hand (qDASH) score at 1 year. Each patient was then treated with a single corticosteroid injection in the proximal forearm at the posterior interosseous nerve (PIN). Patient follow-up occurred at 2 weeks, 3 months, and 1 year. Results: The cohort had a mean age of 49 years, and 35 patients completed 1 year of follow-up. Outcomes based on qDASH and visual analog scale (VAS) showed significant improvement from baseline, with mean qDASH decreasing from 49.4 ± 7.0 points to 35.8 ± 7.5 points (P = .03) and 28.5 ± 7.3 points (P = .01) at 12 and 52 weeks, respectively, and VAS decreasing from 6.0 ± 0.8 points to 3.4 ± 0.9 points (P = .005) and 2.9 ± 0.8 points (P = .003) at 12 and 52 weeks, respectively. During the study period, 8 of 35 patients (23%) failed nonoperative treatment and went on to surgical decompression of the PIN. A minimal clinically important difference in qDASH was achieved in 57% of subjects at 1-year follow-up. Conclusions: Nonoperative management with corticosteroid injection can be used as a therapeutic measure with potential long-term benefits in the treatment of RTS.

Keywords: compressive neuropathy; corticosteroid; injection; radial tunnel; radial tunnel syndrome.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Quick DASH over time. There were significant reductions in quick DASH noted at 12 and 52 weeks compared to baseline after a single cortisone injection into the radial tunnel. DASH = Disabilities of the Arm, Shoulder and Hand.
Figure 2.
Figure 2.
Visual analog scale (VAS) for pain over time. There were significant reductions in visual analog scale for pain noted at 12 and 52 weeks compared with baseline after a single cortisone injection into the radial tunnel.
See this image and copyright information in PMC

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