Clinical inquiries. Are steroid injections effective for tenosynovitis of the hand?

z Evidence summary Flexor tenosynovitis and de Quervain’s tenosynovitis are the 2 most common types of tenosynovitis of the hand. While the term “tenosynovitis” implies an inflammatory condition, pathoanatomically it is better described as a friction overuse injury, resulting in fibrosis Yes. steroid injections are an effective first-line therapy for flexor tenosynovitis of the hand, with a number needed to treat [NNT] of 2.3 for injection of steroids and lidocaine (strength of recommendation [sor]: B, based on 1 prospective rcT and 2 low-quality studies). Injection into the tendon sheath may not be critical to a successful outcome (sor: B, based on 1 prospective uncontrolled trial). For de quervain’s tenosynovitis, steroid injections without splinting are more effective than injection plus splinting or splinting alone. The cure rates are 83% (steroid alone), 61% (steroid plus splinting), and 14% (splinting alone) (sor: B, based on a systematic review of descriptive noncontrolled studies). Injecting into the tendon compartments was more effective than injecting into the surrounding soft tissues (sor: B, based on 1 prospective controlled trial).