title: Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report.
abstract: Local corticosteroid injection into the hand is the preferred initial step in the management of trigger finger owing to its safety and efficacy. We report the case of a patient with shower emboli and digital necrosis after a local corticosteroid injection for the treatment of trigger thumb. Given the patient's subsequent negative hypercoagulability workup, we suspect that the patient's symptoms resulted from the injection of steroids into the princeps pollicis artery, with subsequent retrograde flow into multiple other arteries of the hand. The patient was managed conservatively and ultimately her symptoms resolved. No new areas of digital necrosis have appeared in 8 years of follow-up.
authors.affiliation: Division of Plastic Surgery and the Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL 60610, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Park
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Dumanian
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D004617:Embolism / Q000209:etiology*; D005260:Female; D005385:Fingers / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D007270:Injections, Intra-Articular / Q000009:adverse effects*; D009336:Necrosis / Q000209:etiology; D012883:Skin Ulcer / Q000209:etiology; D013933:Thumb; D052582:Trigger Finger Disorder / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones