Comparable Clinical Outcomes with Ultrasound-Guided and Blind Corticosteroid Injections in Trigger Finger Management

Abstract

Background: Trigger finger is a common hand disorder caused by a mismatch between the flexor tendon and its sheath, leading to pain, swelling, and functional impairment. Corticosteroid injections are a standard treatment, but the efficacy of ultrasound-guided (USG) versus blind-guided (BG) injections remains debated. Objectives: This study aimed to compare the clinical effectiveness of corticosteroid injections administered with and without ultrasound guidance for treating trigger finger. Methods: In this prospective controlled study, 90 patients with trigger finger (Quinnell stages I - III) who failed conservative management were randomized into two groups: Ultrasound-guided injection (USGI, n = 45) and blind injection (BGI, n = 45). Both groups received 1 mL of Methylprednisolone acetate (40 mg/mL) injected extra-sheath beneath the first annular (A1) pulley. Pain (Visual Analogue Scale, VAS), disease severity, and functional disability (Quick Disabilities of the Arm, Shoulder, and Hand, QDASH) were assessed at baseline, 6 weeks, and 12 weeks post-injection. Results: No significant differences were observed between groups in demographics (age, gender, affected hand; P > 0.05). At follow-up, both groups showed comparable improvements in disease severity, pain scores, and QDASH scores (P > 0.05). Although the USGI group had slightly higher mean disease severity at grade 3 and marginally lower pain, these differences were not statistically significant. QDASH scores were also similar between groups. Conclusions: The USG and BG corticosteroid injections demonstrate equivalent efficacy in reducing pain and improving function in trigger finger patients. The choice of injection method may depend on resource availability, clinician expertise, and patient preference. Future studies should incorporate objective biomarkers for further validation.