Authors (including presenting author) :
Choi YK(1), Fan VC(1), Cheuk C(1), Lee MK(1), Leung KW(1)
Affiliation :
(1)Department of Family Medicine, the New Territories East Cluster, Hospital Authority, Hong Kong
Introduction :
Trigger finger is a common musculoskeletal problem in primary care. Corticosteroid injection has been the first-line treatment of trigger fingers and its successful rate ranges from 67-90% after the first injection. It is a procedure that can be safely done in primary care clinic setting and the provision of this service can effectively decrease referrals and lessen the burden of secondary care. While point-of-care USG is gaining popularity in primary care, mastering the skill of USG-guided soft tissue injection can ensure safer and more accurate injection procedures. The Prince of Wales hospital Family Medicine (FM) musculoskeletal clinic has been providing USG guided soft tissue injection since late 2019. We aim to review the USG-guided trigger finger corticosteroid injection outcomes in the clinic.
Objectives :
To evaluate the USG-guided trigger finger corticosteroid injection outcomes by comparing the finger grading and symptoms scores before and after injection.
Methodology :
All trigger fingers cases with USG guided corticosteroid injection done in 2020 were recruited and were retrospectively reviewed till 31st Dec 2020. Data such as Quinnell grading of trigger fingers, Numerical Pain Rating Score (NPRS) and the Quick Disabilities of Arms, Shoulder & Hands (Quickdash) score on the day of injection and at subsequent follow-up visit was collected for analysis.
Result & Outcome :
Result and outcome: 262 patients and a total of 338 fingers received USG guided injection. 108 (41.2%) were males and 154 (58.8%) were females with mean age 65±9.35. Majority of the trigger fingers were grade II (N=216, 63.9%) and grade III (N=115, 34%). The mean follow-up interval after injection was 37.9±12.3 days and 30 (11.5%) cases defaulted follow-up. After injection, 179 (52.9%) of the fingers became grade I and below. The improvement of grading was significant (P< .001). There was significant improvement of both NPRS (mean difference: 4.48±3.0, 95% CI= 4.06-4.89, P< .001) and Quickdash score (mean difference: 15.77±20.14, 95% CI= 13.06-18.48, P< .001). 28 (10.7%) cases had repeated injection of same finger. The mean interval for repeated injection was 167±82.61 days. 26 (9.9%) cases referred to physiotherapy and 2(0.8%) cases referred to orthopaedics. No adverse effect from injections was reported. The data shows that family medicine clinic is able to provide safe USG-guided trigger finger corticosteroid injections with good clinical outcomes.
