Franck Lapègue1,2, Aymeric André3,4, Etienne Pasquier Bernachot5, Ezin Jocelyn Akakpo6, Pierre Laumonerie3,7, Hélène Chiavassa-Gandois5, Omar Lasfar5, Christophe Borel5, Marine Brunet5, Olivia Constans5, Hubert Basselerie5, Nicolas Sans5, Marie Faruch-Bilfeld5. 1. Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France. franck.lapegue@gmail.com. 2. ELSAN, Polyclinique Le Languedoc, Avenue de la Côte des Roses, 11100, Narbonne, France. franck.lapegue@gmail.com. 3. Laboratoire d'anatomie, faculté de médicine, 31062, Toulouse, France. 4. Service de chirurgie orthopédique, clinique Médipole Garonne, 45 rue de Gironis, 31036, Toulouse Cédex1, France. 5. Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France. 6. ISBA, Faculté de médecine du CNHU de Cotonou, Cotonou, Bénin. 7. Institut de l'appareil locomoteur, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France.
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.
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.
Authors: A Volpe; M Pavoni; A Marchetta; P Caramaschi; D Biasi; C Zorzi; G Arcaro; W Grassi Journal: Ann Rheum Dis Date: 2009-11-08 Impact factor: 19.103
Authors: Luca Maria Sconfienza; Miraude Adriaensen; Domenico Albano; Maria Pilar Aparisi Gómez; Alberto Bazzocchi; Ian Beggs; Bianca Bignotti; Vito Chianca; Angelo Corazza; Danoob Dalili; Miriam De Dea; Jose Luis Del Cura; Francesco Di Pietto; Eleni Drakonaki; Fernando Facal de Castro; Dimitrios Filippiadis; Jan Gielen; Salvatore Gitto; Harun Gupta; Andrea S Klauser; Radhesh Lalam; Silvia Martin; Carlo Martinoli; Giovanni Mauri; Catherine McCarthy; Eugene McNally; Kalliopi Melaki; Carmelo Messina; Rebeca Mirón Mombiela; Benedikt Neubauer; Marina Obradov; Cyprian Olchowy; Davide Orlandi; Athena Plagou; Raquel Prada Gonzalez; Saulius Rutkauskas; Ziga Snoj; Alberto Stefano Tagliafico; Alexander Talaska; Violeta Vasilevska-Nikodinovska; Jelena Vucetic; David Wilson; Federico Zaottini; Marcello Zappia; Georgina Allen Journal: Eur Radiol Date: 2019-12-16 Impact factor: 5.315