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The purpose of this study is to determine if corticosteroid injection modifies the natural course of de Quervain tendinopathy compared to a toradol injection.
If steroids are effective for Dequervain tenosynovitis because of their anti-inflammatory properties, then there is a reasonable and rational argument to be made for the local injection of NSAIDS (non-steroidal anti-inflammatory drugs) into the first dorsal extensor compartment. Ketorolac is an NSAID that has been proven efficacious in the treatment of another musculoskeletal condition. Moreover, compared to betamethasone (or other injectable corticosteroids), injection of ketorolac decreases the patient exposure to the potential side-effects of corticosteroids, especially that of elevation of blood sugar levels in diabetics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Betamethasone | Active Comparator | 1 cc of 1% lidocaine (without epinephrine) plus 1 cc of 6 mg/ml betamethasone (Celestone) |
|
| Ketorolac | Experimental | 1 cc of 1% lidocaine (without epinephrine) plus 1 cc of 30 mg/ml of ketorolac (Toradol) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| betamethasone | Drug | 1 cc of 1% lidocaine (without epinephrine) plus 1 cc of 6 mg/ml betamethasone |
|
| Measure | Description | Time Frame |
|---|---|---|
| Visual analog scale (VAS) of pain with finklestein test | Visual Analog Scale (VAS) of pain measured on 0 (no pain) - 10 (worst possible pain) | 6 weeks post injection |
| Measure | Description | Time Frame |
|---|---|---|
| Visual analog scale (VAS) of pain with tenderness over tendon | Visual Analog Scale (VAS) of pain measured on 0 (no pain) - 10 (worst possible pain) | pre injection, 2 weeks post injection, 6 weeks post injection |
| Visual analog scale (VAS) of pain on radial side of wrist |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christopher Chadderdon, MD | OrthoCarolina Research Institute, Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| OrthoCarolina | Charlotte | North Carolina | 28207 | United States |
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| ID | Term |
|---|---|
| D001623 | Betamethasone |
| D020910 | Ketorolac |
| D020911 | Ketorolac Tromethamine |
| ID | Term |
|---|---|
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
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| Ketorolac | Drug | 1 cc of 1% lidocaine (without epinephrine) plus 1 cc of 30 mg/ml of ketorolac |
|
|
Visual Analog Scale (VAS) of pain measured on 0 (no pain) - 10 (worst possible pain) |
| pre injection, 2 weeks post injection, 6 weeks post injection, 3 months post injection, 6 month post injection |
| The Disabilities of the Arm, Shoulder, and Hand Score (DASH) | Patient-reported evaluation of symptoms as well as ability to perform certain activities. Score is 0-100 (higher scores indicate greater disability). Must answer at least 27/30 questions. Score is 1 to 5 per question. Score is then summed and divided by the number of completed questions. subtract 1 from this number then multiply by 25. | pre injection, 2 weeks post injection, 6 weeks post injection, 3 months post injection, 6 months post injection |
| Veterans-Rand 12 (VR-12) | Quality of life using VR-12 subscores. Physical Health (PCS) subscore and Mental Health (MCS) subscore, not summed. Range reported in weighted units. Both PCS/MCS are score 0-100 with 100 indicating the highest level of health. | pre injection, 2 weeks post injection, 6 weeks post injection, 3 months post injection, 6 months post injection |
| Pinch Strength | pre-injection, 2 weeks post injection, 6 weeks post injection |
| Grip Strength | pre injection, 2 weeks post injection, 6 weeks post injection |
| D000072473 |
| Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
| D007213 | Indomethacin |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |