Abstract Archives of the RSNA, 2011
Davide Orlandi MD, Presenter: Nothing to Disclose
Luca Maria Sconfienza MD, Abstract Co-Author: Nothing to Disclose
Giulio Ferrero, Abstract Co-Author: Nothing to Disclose
Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose
Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose
Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose
Trigger finger is a common disorder of the hand, characterized by snapping or locking of the flexor tendons of the affected finger, associated with mechanical dysfunction and pain. Steroid injection or surgery are currently considered the standard of treatment. Recently, an ultrasound-guided injection technique of hyaluronate has been described. Our aim was to compare such a technique to a different US-guided approach.
Twenty-six patients (13 females; mean age 42±7.6 years) who presented at our department to be treated for trigger finger were included in our study. They were treated by US-guided intra-sheath injection of steroid and a 15-day delayed US-guided intra-sheath injection of hyaluronate. Patients were priory randomized into two groups. Group A (5 females; mean age 41±7.3 years) was treated using an already-described technique, injecting the drugs using the needle parallel to the tendon course, while group B (8 females; mean age 43±7.5 years) was treated with a new technique, that implies the injection of the drugs using the needle perpendicular to the tendon course. For each patient, we noted the efficacy of the treatment at 15,30, 60, and 120 days by a semi-quantitative scale (from 0 to 3), pain during procedure evaluated using a VAS scale (pain score from 0 to 10), and the time of the procedure. K and U Mann-Whitney statistics were used.
No immediate or delayed complication were observed. No differences were observed in terms of treatment efficacy between group A and B at all time-points (median value=3 for both groups, p=n.s.). Pain during procedure was significantly lower in group B (mean VAS score=5.8±2.2) than in group A (7.2±2.4; p<.012). Procedure time was significantly lower in group B (mean time= 84±24 s) than in group A (122±32 s; p<.021).
US-guided treatment of trigger finger is effective using both parallel and perpendicular approach. This latter allows for a significant reduction of procedure time and pain perceived by patients during the procedure.
Perpendicular approach when performing an US-guided treatment of trigger finger allows for procedure time and pain reduction.
Ultrasound-guided Treatment of Trigger Finger: An Alternative Approach. Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005515.html