US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases

Franck Lapègue (1) , Aymeric André (2) , Etienne Pasquier Bernachot (1) , Ezin Jocelyn Akakpo (3) , Pierre Laumonerie (1, 2) , Hélène Chiavassa-Gandois (1) , Omar Lasfar (1) , Christophe Borel (1) , Marine Brunet (1) , Olivia Constans (1) , Hubert Basselerie (1) , Nicolas Sans (1) , Marie Faruch-Bilfeld (1)

1 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
2 UT3 - Université Toulouse III - Paul Sabatier
3 CNHU-HKM - Centre National Hospitalier Universitaire Hubert K. Maga de Cotonou

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.

Mots clés: De Quervain disease; Injections; intralesional; Tendon entrapment; Tenotomy; Ultrasonography; interventional

Domaines: Rhumatologie et système ostéo-articulaire; Imagerie

Franck Lapègue, Aymeric André, Etienne Pasquier Bernachot, Ezin Jocelyn Akakpo, Pierre Laumonerie, et al.. US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases. European Radiology, 2018, 28 (9), pp.3977-3985. ⟨10.1007/s00330-018-5387-1⟩. ⟨hal-02135110⟩