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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Acute horseshoe abscess of the hand after corticosteroid injection to treat trigger thumb
  1. Nikki Shah,
  2. Stephen Mulgrew,
  3. Tereze Laing
  1. Plastic Surgery, Addenbrooke’s Hospital, Cambridge, UK
  1. Correspondence to Nikki Shah, nikkishah2191{at}doctors.org.uk

Summary

Local corticosteroid injections are frequently used in the management of trigger finger. We present a case of a 56-year-old woman who developed an acute horseshoe abscess of the hand after injection of corticosteroid and local anaesthetic into the left thumb. This was managed successfully with intravenous antibiotics, operative intervention and early mobilisation. This case highlights the possible complications that can occur with such a minimally invasive procedure. The pathophysiology behind this condition is explained by communication between the radial and ulnar bursae. Knowledge of the anatomy of the hand and its variants is therefore essential to assist in diagnosis. Prompt clinical diagnosis and surgical management is required to avoid disastrous complications.

  • infections
  • plastic and reconstructive surgery

https://doi.org/10.1136/bcr-2018-225535

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    Footnotes

    • Contributors The manuscript was written by NS. SM and TL were involved in editing the article. All authors were involved in the management of the patient and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.