title: A Meta-Analysis of the Effect of Corticosteroid Injection for Enthesopathy of the Extensor Carpi Radialis Brevis Origin.
abstract: OBJECTIVE
  The null hypothesis that there is no effect of corticosteroid injection on visual analog scale for pain in patients with enthesopathy of the extensor carpi radialis brevis (eECRB) origin 6 months after treatment was tested. Our secondary hypotheses were that there is no effect of corticosteroid injection on pain intensity at 1 and 3 months after treatment; that there is no effect of corticosteroid injection on grip strength at 1, 3, and 6 months after treatment; and that there is no effect of corticosteroid injection on Disabilities of the Arm, Shoulder, and Hand scores at 1, 3 and 6 months after treatment.
  
  
  METHODS
  EMBASE, PubMed Publisher, MEDLINE, OvidSP, Web of Science, Google Scholar, and the Cochrane Central were searched for relevant studies. Studies were eligible if there was (1) a description of corticosteroid injection treatment for eECRB; (2) randomized placebo injection-controlled trials with at least 10 adults included with eECRB; (3) a full-text article available with data describing the mean differences between the corticosteroid and the control groups and the outcome measures used; and (4) follow-up of at least 1 month. In total, 7 randomized controlled trials comparing the effect of corticosteroid injection with a placebo injection on symptoms of eECRB were included in our meta-analysis.
  
  
  RESULTS
  We found no difference in pain intensity 6 months after injection of corticosteroids or placebo. Pain intensity was slightly, but significantly, lower 1 month, but not 3 months, after steroid injection. There were no significant differences in grip strength or Disabilities of the Arm, Shoulder, and Hand score at any time point.
  
  
  CONCLUSIONS
  This meta-analysis showed that there is no difference in pain intensity between corticosteroid injection and placebo 6 months after injection. We interpret the weight of evidence to date as suggesting that corticosteroid injections are neither meaningfully palliative nor disease modifying when used to treat eECRB.
  
  
  METHODS
  Therapeutic I.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital-Harvard Medical School, Boston, MA.
authors.forename: Femke M A P
authors.initials: FMAP
authors.lastname: Claessen
authors.affiliation: Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA.
authors.forename: Balthasar A
authors.initials: BA
authors.lastname: Heesters
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital-Harvard Medical School, Boston, MA.
authors.forename: Jimmy J
authors.initials: JJ
authors.lastname: Chan
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital-Harvard Medical School, Boston, MA.
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Kachooei
authors.affiliation: Department of Hand Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, MA. Electronic address: david.ring@austin.utexas.edu.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000070676:Enthesopathy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D010147:Pain Measurement / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013716:Tennis Elbow / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Corticosteroid; enthesopathy of the extensor carpi radialis brevis; meta-analysis; tennis elbow