Ultrasound-Guided Versus Landmark-Guided Corticosteroid Injections for De Quervain's Tenosynovitis: A Retrospective Comparative Study

De Quervain's tenosynovitis is a condition characterized by radial-sided wrist pain. Corticosteroid injections are a common first-line treatment, though treatment outcomes of ultrasound relative to landmark-guided techniques remain unclear. This retrospective cohort study compared the efficacy of corticosteroid injections performed with and without ultrasound.

This study was conducted at a single health care organization. Patients ≥18 years old, diagnosed with De Quervain's tenosynovitis, who received a corticosteroid injection between October 2021 and October 2025 were included. The primary outcome was treatment success, defined as maintenance of relief without additional intervention or stated discontinuation of relief, and was evaluated at 3, 12, and 24 months post-injection. Secondary outcomes included treatment durability, defined as time to treatment failure, further stratified into time to surgical intervention, repeat injection, and stated discontinuation of relief.

A total of 189 patients met the inclusion criteria, including 93 who received ultrasound-guided injections and 96 who received landmark-guided injections. No significant differences in treatment success were observed at 3, 12, or 24 months. There were also no significant differences between either the rate of surgical conversion (24.7% vs 24.0%, P = 1.00) or time to surgical release (162.0 vs 203.4 days, P = .52).

Ultrasound-guided corticosteroid injections were not associated with improved treatment success or lower surgical conversion rates compared with landmark-guided injections in this retrospective cohort. These findings suggest that routine ultrasound use may not provide a clear clinical advantage in all patients, although ultrasound may remain useful based on provider preference and clinical judgment.