Cheiralgia paresthetica and linear atrophy as a complication of local steroid injection

Cheiralgia paresthetica, a mononeuropathy of the superficial branch of the radial nerve, is an uncommon problem, usually resulting from local trauma to the wrist. This report describes a 27-year-old patient who developed subdermal atrophy following local hydrocortisone injection as a treatment for deQuervain's tenosynovitis. Subsequently, she developed linear skin atrophy, a rare complication of steroid injection thought to result from lymphatic spread of the steroid suspension, extending proximally from the initial atrophic area in her hand into her forearm. Soon after wearing a wristwatch on the affected wrist, she developed symptoms of cheiralgia paresthetica. Linear atrophy was found to traverse the superficial radial nerve and was considered to contribute to the symptoms. It is important to be aware that subcutaneous atrophy may follow the lymphatics with injections of steroid.