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Hand, infiltration de Quervain
 Tendon sheath abd. pollicis longus and ext. pollicis brevis
PATIENT'S POSTURE The patient sits with his forearm at mid-rotation lying on a cushion on the couch ; thumb fully flexed (possibly held by an assistant) and wrist in full ulnar deviation and slight extension beyond the edge of the cushion.
PRODUCT 0.5 ml - 1 ml triamcinolone acetonide (10 mg/ml)
SYRINGE 1 ml tuberculin syringe
NEEDLE 0.6x25 mm (23 G1)
TECHNIQUE A point is chosen level with the dorsal distal edge of the base of the first metacarpal bone. The needle is inserted horizontally a short way ; thumb and index finger grasp both tendons. The needle is thrust in further, almost parallel to the tendon, in an attempt at piercing the common tendon sheath (without any resistance). A small amount is now injected and a little sausage forms from the piercing point in the tendon sheath towards the radius. Only when this little sausage appears, the rest of the product can be injected.
If not, the needle should be repositioned.
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Linking with other Cyriax items |
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