Ultrasound-guided methotrexate injection for De Quervain disease of the wrist: what lies beyond the horizon?

Abstract

De Quervain disease (DQVD) is one of the most common causes of lateral wrist pain and can lead to significant disability. The current case involves a right-handed, middle-aged, female patient with severe lateral wrist pain due to DQVD. Her pain was not responsive to oral non-steroidal anti-inflammatory drugs, rehabilitation, and repeated corticosteroid injections. Because she refused surgical intervention, we performed ultrasound-guided methotrexate injections (four times). After the injections, dramatic pain relief, functional improvement, and reduction of the thickness of the retinaculum and tendons in the first dorsal extensor compartment of the wrist were noted. This case report highlights the potential usefulness of ultrasound-guided methotrexate injection for recalcitrant DQVD of the wrist.

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Keywords:

• hand
• pain
• sonography
• rehabilitation

Acknowledgments

The current research project was supported by the National Taiwan University Hospital, Bei-Hu Branch and the Ministry of Science and Technology (104-2314-B-002-022-MY2 and 106-2314-B-002-180-MY3).

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.