Embedded Files
Evidence Grade B: Corticosteroid injection as the first line therapeutic treatment option.
Obtain informed consent from the patient.
Gather appropriate equipment needed for the procedure.
First, draw up 1cc of 1% lidocaine into a 5cc syringe.
Then draw up the steroid into the same syringe in order to intermix them together. You may use this list of four commonly used steroids as a reference.
Identify the extensor tendons involved in de Quervain's (abductor pollicis longus and extensor pollis brevis).
Have the patient fully abduct their thumb.
Palpate along the radial styloid to find the point of maximal tenderness.
Cleanse the skin with iodine or an alcohol swab.
In this image: Have the patient fully abduct their thumb.
Using a 25-gauge, 1.5-inch needle, insert the needle parallel to the tendon.
You may approach the injection with the needle aiming distally or proximally, as long as you inject along the tendon. You should be injecting into the tendon sheath, and not the actual tendon.
The medication should flow freely.
In this image: The physician inserts the needle parallel to the tendon.
To complete the procedure:
Withdraw the needle and apply pressure.
Cover your injection site with a sterile bandage.
Post-injection care is important for successful relief of pain in de Quervain's tenosynovitis.
What kinds of things would you advise your patient? Rest, ice, splint, and avoid grasping.
Page updated
Report abuse