RESEARCH - Corticosteroid injections effective for trigger finger in adults in general practice

August 16, 2008

ls of the Rheumatic Diseases 2008;67:1262-1266

Rheumatism

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EXTENDED REPORTS

Corticosteroid injections effective for trigger finger in adults in

general practice: a double-blinded randomised placebo controlled trial

C s-Veluthamaningal , J C Winters , K H Groenier , B Meyboom-de Jong

Department of General Practice, University Medical Center Groningen,

Groningen, The Netherlands

Objective: To study efficacy and safety of corticosteroid injections

for trigger finger (flexor tenosynovitis) in adults in general

practice.

Methods: Adult patients presenting with trigger finger were recruited

by 21 participating general practitioners. In this randomised placebo

controlled double-blinded trial, patients were injected locally with

one or two injections of 1 ml triamcinolonacetonide (TCA) or 0.9%

NaCl. Outcomes regarding immediate treatment response, severity of

symptoms, functional disability, patient satisfaction and side effects

were measured 1 week after intervention and during the 12 months

thereafter.

Results: A total of 50 patients were included. Short-term outcomes for

the TCA and NaCl group, respectively, were: proportion of patients

with satisfactory immediate treatment response 16/25 and 5/25

(p<0.001), patients with reduction in the frequency of triggering

13/24 and 6/22 (p = 0.053), mean difference in severity of pain 4.2

and 0.9 (p<0.001), patients perceiving improvement 22/25 and 9/25

(p<0.001) and difference in Arthritis Impact Measurement Scale 2

(AIMS-2) score 4.02 and 0.06 (p = 0.001). Long-term effects could only

be assessed by analysing the cohort of participants who received TCA

(as allocated treatment or escape treatment), due to a high proportion

of non-responders in the NaCl group. The short-term beneficial effects

were maintained during the follow-up phase of 12 months. Patients were

satisfied with corticosteroid injection therapy and there were only a

few minor side effects.

Conclusions: Local injection with TCA is effective and safe for

treating trigger finger as compared to placebo injection. The effects

of steroid injections last up to 12 months.

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Not an MD

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