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De Quervain Injection
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| De Quervain Injection | |
|---|---|
| Indication | De Quervain Tendinopathy |
| Syringe | 1mL |
| Needle | 25G 16mm |
| Steroid | 10-20mg triamcinolone |
| Local | 0.75mL 2% lidocaine |
| Volume | 1mL |
Background
Injection for De Quervain Tendinopathy.
Anatomy
The APL and EPB usually run together in the first dorsal compartment. The tendons can often be seen with the thumb held in resisted extension. They can also be palpated at the base of the 1st metacarpal.
Technique
- The aim is to inject between the two tendons within the sheath
- Position: Ulnar side of hand resting on surface with thumbheld in slight flexion
- Identify the gap between the two tendons
- Insert needle perpendicularly into the gap then slide proximally between the tendons (needle going distal to proximal)
- Inject solution as a bolus
Complications
- Subcutaneous fat atrophy, particularly noticeable in dark skinned thin women. This may be permanent but generally resolves within 3 months. The risk can be reduced by using hydrocortisone.
- Trauma to superficial radial nerve
Aftercare
Rest hand for one week with taping. Avoid provoking activities and start a graded load programme.
