Aims and objectives
To assess the efficacy of ultrasound (US) guided injections of hyaluronic acid and steroid injection for trapeziometacarpal joint osteoarthritis (TMC OA).
The TM joint,
the articulation between the first metacarpal and the trapezium,
is crucial for normal mobility and functionality of the thumb.
Performing TM joint procedures,
the physicians have to consider many surrounding structures,
such as the superficial radial nerve and the radial artery.
it must be pointed out the TM...
Methods and materials
Twenty for patients (12 men,
mean age 63.1 years) with TMC OA were injected either with corticosteroid + hyaluronic acid (group 1) or corticosteroids alone (group 2),
each patient received 2 joint injections distanced of 15 days.
we used Triamcinolone.
Pre-treatment evaluation included Eaton-Littler radiographic classification,
US assessment of joint capsule distension,
assessment of visual analogue pain scores (VAS) and of Disabilities of the Arm,
10 patients displayed a grade 2 according to Eaton-Littler classification,
10 patients a grade 3 and 4 patients a grade 4.
Concerning US evaluation,
18 patients showed a relevant joint capsule distension.
Analysing clinical response, the group 1 showed an improvement of VAS scale after 3 months of follow up,
specifically the baseline VAS decreased after 3 months of follow up from median 7 (range 4-9) to median 3 (range 0-5).
The group 2 also showed an improvement of VAS,
In our study,
the therapeutic strategies were associated with an improvement of clinical parameters after 3 month of follow-up.
A slight difference was observed in DASH response comparing the 2 groups
Ultrasonography-guidedInterventional Proceduresof the Wrist and Hand Anatomy,
Jay Smith. http://dx.doi.org/10.1016/j.pmr.2016.04.003