Utility of Patient-Reported Outcomes in Prognosis of Corticosteroid Injection Treatment Success for Trigger Finger and de Quervain's Stenosing Tenosynovitis.

Abstract

Background: Corticosteroid injections are a first-line treatment of trigger finger and de Quervain's tenosynovitis. Little research has evaluated preinjection patient-reported outcomes as a predictive factor for treatment success following corticosteroid injection. We hypothesized that patients with less pretreatment impairment would demonstrate greater post-treatment improvement than patients whose function was more severely impaired.

Methods: We retrospectively reviewed prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) scores in patients undergoing corticosteroid injection for trigger finger or de Quervain's tenosynovitis from 2017 to 2023. Independent variables were patient baseline characteristics, comorbidities, and baseline PROMIS UE. The primary outcome was treatment success between 30 days and 12 weeks, defined as achieving the minimal clinically important difference for PROMIS UE without undergoing surgery.

Results: In total, 240 trigger finger and 74 de Quervain's tenosynovitis patients (N = 314) were analyzed. Following injection, 63 (20.1%) patients achieved treatment success, 86 (27.4%) underwent surgical release, and 165 (52.5%) did not significantly improve function or undergo surgery. Each 1-point increase in baseline PROMIS UE was associated with 10% lower odds of treatment success (P < .001). Among nonoperative patients, each 1-point increase in baseline PROMIS UE was associated with a 0.51-point decrease in PROMIS UE score (P < .001) and diabetes was associated with a 2.74-point decrease in PROMIS UE after injection (P = .44).

Conclusion: Corticosteroid injection provides meaningful improvement for a subset of trigger finger and de Quervain's tenosynovitis patients. Corticosteroid injection remains a first-line treatment for trigger finger and de Quervain's tenosynovitis patients, especially for those with more severe functional impairment.