OLGU SUNUMLARI
De Quervain Tenosinovitinde Kortikosteroid Enjeksiyonu Sonrası Gelişen Geçici Hipopigmentasyon ve Atrofi
Reversible Hypopigmentation and Atrophy After Corticosteroid Injection in De Quervain’s Tenosynovitis
Received Date : 14 Oct 2024
Accepted Date : 27 Apr 2025
Available Online : 14 May 2025
Esra ŞAHİNGÖZ BAKIRCIa, Gülseren DEMİR KARAKILIÇb, Ferda SURELc
aYozgat Bozok University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Yozgat, Türkiye
bYozgat City Hospital, Clinic of Physical Medicine and Rehabilitation, Yozgat, Türkiye
cAnkara Bilkent City Hospital, Clinic of Physical Medicine and Rehabilitation, Ankara, Türkiye
Doi: 10.31609/jpmrs.2024-106237 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2025;28(3):316-9.
ÖZET
De Quervain tenosinoviti, el bileği birinci dorsal kompartımanda yer
alan abduktor pollicis longus ve ekstansor pollicis brevis tendonlarının tekrarlayan
hareketler ve aşırı kullanımı sonucu oluşan stenozan tenosinovitidir.
Tedavide ilk olarak konservatif yöntemler kullanılmaktadır. Konservatif
tedavide fizik tedavi yöntemleri, immobilizasyon sağlamak amaçlı splintler,
steroid olmayan antiinflamatuar ilaçlar ve tendonlarındaki irritasyon ve inflamasyonu
azaltmak için kortikosteroid (KS) enjeksiyonları kullanılmaktadır.
Cilt hipopigmentasyonu ve subkutan yağ doku atrofisi KS
enjeksiyonlarının dermal yan etkilerindendir. Biz bu olgu sunumunda De
Quervain tenosinovit tedavisinde kör teknikle yapılan triamsinolon asetonid
enjeksiyonu sonrası el bileğinin radyal yüzünde reversibl subkutan yağ
doku atrofisi ve cilt hipopigmentasyonu gelişen bir olguyu sunmayı ve bu
konuda önerilerde bulunmayı amaçlıyoruz.
Anahtar Kelimeler: Atrofi; De Quervain tenosinoviti; hipopigmentasyon; kortikosteroid
ABSTRACT
De Quervain tenosynovitis is a stenosing tenosynovitis that
occurs as a result of repetitive movements and overuse of the abductor pollicis
longus and extensor pollicis brevis tendons located in the 1st dorsal
compartment of the wrist. Conservative methods are used 1st in the treatment.
Physical therapy methods, splints for immobilization, nonsteroidal
anti-inflammatory drugs, and corticosteroid (CS) injections are used to reduce
irritation and inflammation in the tendons. Skin hypopigmentation and
subcutaneous adipose tissue atrophy are the dermal side effects of CS injections.
In this case report, we aim to present a case in which reversible
subcutaneous adipose tissue atrophy and skin hypopigmentation developed
on the radial side of the wrist after triamcinolone acetonide injection performed
with a blind technique in the treatment of De Quervain tenosynovitis
and to make recommendations on this subject.
Keywords: Atrophy; De Quervain tenosynovitis; hypopigmentation; corticosteroid
REFERENCES
- Challoumas D, Ramasubbu R, Rooney E, Seymour-Jackson E, Putti A, Millar NL. Management of de Quervain tenosynovitis: a systematic review and network meta-analysis. JAMA Netw Open. 2023;6:e2337001. [PubMed] [PMC]
- Fakoya AO, Tarzian M, Sabater EL, Burgos DM, Maldonado Marty GI. De Quervain's disease: a discourse on etiology, diagnosis, and treatment. Cureus. 2023;15:e38079. [Crossref] [PubMed] [PMC]
- Ilyas AM, Ast M, Schaffer AA, Thoder J. De quervain tenosynovitis of the wrist. J Am Acad Orthop Surg. 2007;15:757-64. Erratum in: J Am Acad Orthop Surg. 2008;16(2):35A. Ilyas, Asif [corrected to Ilyas, Asif M]. [PubMed]
- Abi-Rafeh J, Mojtahed Jaberi M, Kazan R, Alabdulkarim A, Boily M, Thibaudeau S. Utility of ultrasonography and significance of surgical anatomy in the management of de Quervain disease: a systematic review and meta-analysis. Plast Reconstr Surg. 2022;149:420-34. [PubMed]
- Stone S, Malanga GA, Capella T. Corticosteroids: review of the history, the effectiveness, and adverse effects in the treatment of joint pain. Pain Physician. 2021;24:S233-S246. [PubMed]
- Brinks A, Koes BW, Volkers AC, Verhaar JA, Bierma-Zeinstra SM. Adverse effects of extra-articular corticosteroid injections: a systematic review. BMC Musculoskelet Disord. 2010;11:206. [PubMed] [PMC]
- Stephens MB, Beutler AI, O'Connor FG. Musculoskeletal injections: a review of the evidence. Am Fam Physician. 2008;78:971-6. [PubMed]
- Shah A, Mak D, Davies AM, James SL, Botchu R. Musculoskeletal corticosteroid administration: current concepts. Can Assoc Radiol J. 2019;70:29-36. [Crossref] [PubMed]
- Özcan F, Karabay İ, Gürçay E. Mediyal epikondilitte steroid enjeksiyonu ile ilişkili atrofi ve hipopigmentasyon: sira dişi bir olgu [Atrophy and hypopigmentation related to steroid injection in medial epicondylitis: an extraordinary case report]. Fiziksel Tup ve Rehabilitasyon Bilimleri Dergisi. 2021;24:84-7. [Crossref]
- Prihatsari F, Hidayati HB, Damayanti D, Budisulistyo T. Hypopigmentation and subcutaneous fat atrophy associated with corticosteroid injection: a case report. Anaesthesia, Pain&Intensive Care. 2021;25:807-11. [Crossref]
- Milani C, Lin C. Proximal linear extension of skin hypopigmentation after ultrasound-guided corticosteroid injection for de Quervain tenosynovitis: a case presentation. PM R. 2018;10:873-6. [PubMed]
- Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65:S59-61. [Crossref] [PubMed] [PMC]
- Shin YH, Choi SW, Kim JK. Prospective randomized comparison of ultrasonography-guided and blind corticosteroid injection for de Quervain's disease. Orthop Traumatol Surg Res. 2020;10:301-6. [PubMed]
