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Injections of the Hand and Wrist: Part II. Carpal Tunnel Syndrome, Ganglion Cyst, Intersection Syndrome, Triangular Fibrocartilage Complex Injury, and de Quervain Tenosynovitis

Injections of the Hand and Wrist: Part I. Trigger Finger, First Carpometacarpal Joint Osteoarthritis, and Palmar Fibromatosis

George G. A. Pujalte, MD
Rock Vomer, DO, DPT
Neil Shah, MD

American Family Physician. 2024;110(4):395-401.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

This is one of a series of articles produced in collaboration with the American Medical Society for Sports Medicine.

Family physicians are well-positioned to provide injections for patients who have pain due to hand and finger conditions, especially when initial treatments such as splinting and nonsteroidal anti-inflammatory drugs are ineffective. Corticosteroid injections can offer pain relief; however, potential risks such as infection, cartilage damage, and skin depigmentation should be discussed. Techniques and procedures for injections vary. Corticosteroid injections for ste-nosing flexor tenosynovitis (trigger finger) can be performed with or without ultrasound guidance. To maximize benefits of corticosteroid injection for carpometacarpal joint osteoarthritis, topical nonsteroidal anti-inflammatory drugs and other conservative treatment modalities should be used concurrently. Because of the risks of disease recurrence and adverse effects, corticosteroid injections for palmar fibromatosis should be approached with caution in the context of shared decision-making.

GEORGE G. A. PUJALTE, MD, CAQSM, FACSM, FAMSSM, FAAFP, is a consultant in the departments of family medicine and orthopedics and sports medicine, an associate professor of family medicine, and an assistant professor of orthopedics at the Mayo Clinic College of Medicine and Science, Jacksonville, Fla. Dr. Pujalte is also the vice chair of research in the Department of Family Medicine at Mayo Clinic, Jacksonville.

ROCK VOMER, DO, DPT, is a primary care and sports and performance medicine physician, Avance Care, Wilmington, N.C.; and a research collaborator in the Department of Family Medicine at Mayo Clinic, Jacksonville.

NEIL SHAH, MD, is a resident physician in the department of family medicine at Mayo Clinic, Jacksonville.

Address correspondence to George G. A. Pujalte, MD, at pujalte.george@mayo.edu.

Author disclosure: No relevant financial relationships.

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Injections of the Hand and Wrist: Part II. Carpal Tunnel Syndrome, Ganglion Cyst, Intersection Syndrome, Triangular Fibrocartilage Complex Injury, and de Quervain Tenosynovitis

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