Procedure

Wrist Extensor Tenosynovitis Corticosteroid Injection

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Wrist Extensor Tenosynovitis Corticosteroid Injection, Intersection Syndrome Steroid Injection

  • See Also
  1. Intersection Syndrome
  2. Overuse Syndromes of the Hand and Wrist
  3. Wrist Injection
  • Preparation
  1. Syringe 3 ml
  2. Needle 25 to 27 gauge (1.25 to 1.5 inch)
  3. Methylprednisolone 20 mg (0.5 ml of 40 mg/ml solution)
  4. Lidocaine 1% 0.5 ml
  • Technique
  1. Patient positioned seated with wrist pronated and palm resting on a table
  2. Identify region of intersection
    1. Dorsal, radial wrist, typically 5 cm proximal to the wrist joint
    2. Region of overlap between dorsal compartment 1 and 2
    3. Palpable tenderness or swelling
  3. Injection Target is within bursa of Compartment 2 tendons
    1. Extensor Carpi Radialis Longus (ECRL)
    2. Extensor Carpi Radialis Brevis (ECRB)
  4. Ultrasound Guidance with high frequency linear probe
    1. Place probe transverse (short axis, horizontal) to tendons at intersection of compartment 1 and 2
  5. Prepare the skin with antiseptic (e.g. Chlorhexidine, Povidone-Iodine)
  6. Inject the region of tendon cross-over and bursa
    1. Avoid injecting into the tendon
  • References
  1. Pujalte (2024) Am Fam Physician 110(4): 402-10 [PubMed]
  2. Waryasz (2017) R I Med J 100(2):31-4 +PMID: 28246658 [PubMed]