Corticosteroid Injection for Treatment of de Quervain’s Tenosynovitis: A Pooled Quantitative Literature Evaluation

Background: There have been many approaches described to treat de Quervain’s tenosynovitis, but no definite consensus emerges in the literature. We conducted a pooled quantitative literature evaluation to review the therapeutic studies in the English language to determine the various reported cure rates. Methods: All citations in the MEDLINE and Ovid databases that addressed de Quervain’s tenosynovitis were independently reviewed. Appropriate studies from the bibliographies of these articles were then obtained. Of the 35 articles on de Quervain’s temosynovitis that were found in the modern literature, only seven allowed for comparison among potentially effective treatments. Studies were included if they evaluated or compared treatment options among patients and had defined criteria for diagnosis and successful treatment. These seven studies were descriptive, not comparative. In other words, each study reported the proportion of successful outcomes with different treatments, without a comparison to a specified control group. Four hundred fifty-nine wrists were subjected to one of several therapeutic mo-dalities. Results: There was an 83 % cure rate with injection alone. This rate was much higher than any other therapeutic modality (61 % for injection and splint, 14 % for splint alone, 0 % for rest or nonsteroidal anti-inflammatory drugs). Conclusion: It seems that injection alone is the best therapeutic approach to de Quervain’s tenosyno-vitis. (J Am Board Fam Pract 2003;16:102–6.) In 1895, Fritz de Quervain, a Swiss surgeon, first described tenosynovitis within the first dorsal wrist extensor compartment at the radial styloid. The usual complaint was pain in the region of the wrist joint. De Quervain’s tenosynovitis is a painful and often dis-abling condition that is mainly observed in workers who perform repetitive manual tasks, wrestlers, and bowlers. Since the original description, a variety of methods have been recommended to treat this teno-synovitis, which involves the abductor pollicis longus and extensor pollicis brevis (Figure 1a and Figure 1b). The purpose of this study was to define the most effective therapeutic approach to this condition based on a consensus standard from the available literature, if one existed