Jonathan Wride

Hi Steve,

Have you any good resources tips on best injection approach for the ECU?

Also with De Quervains and injections do you find better results if you specifically inject under the thickened retinaculum or are happy to just infiltrate into the sheaths slightly distal and let the steroid work its way around? In my experience injecting under the retinaculum is a lot more uncomfortable for patient and not sure if increases efficacy.

Finally just a quick one on CTS. I had a patient yesterday who clinically had every positive test for CTS (phalans, Tinnels, Nocturnal pain and numbness with a repetitive strain mechanism working as a chef) but the median nerve quite frankly looked normal (maybe a bit excessively flattened but only 8mm2 cross section). Symptoms only present for 6 weeks. My question is in these obvious clinical presentations that are relatively acute would you not expect to see much sonographic evidence?

thanks 🙂 love this forum by the way, really great work on the website and resources.


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