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Am Fam Physician. 2024;110(4):395-401

This is one of a series of articles produced in collaboration with the American Medical Society for Sports Medicine.

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Family physicians are well-positioned to provide injections for patients who have pain due to hand and finger conditions, especially when initial treatments such as splinting and nonsteroidal anti-inflammatory drugs are ineffective. Corticosteroid injections can offer pain relief; however, potential risks such as infection, cartilage damage, and skin depigmentation should be discussed. Techniques and procedures for injections vary. Corticosteroid injections for ste-nosing flexor tenosynovitis (trigger finger) can be performed with or without ultrasound guidance. To maximize benefits of corticosteroid injection for carpometacarpal joint osteoarthritis, topical nonsteroidal anti-inflammatory drugs and other conservative treatment modalities should be used concurrently. Because of the risks of disease recurrence and adverse effects, corticosteroid injections for palmar fibromatosis should be approached with caution in the context of shared decision-making.

The hand and wrist complex comprises 27 bones and multiple tendons, muscles, ligaments, and nerves. This complex is integral for performing daily tasks. Hand and wrist injuries represent 25% of all sports-related injuries and can have a major effect on functional activities of daily living.1 The incidence of these injuries is on the rise as the number of people engaging in sports and active recreational activities is increasing. This article, part I of a two-part series on injections of the hand and wrist, addresses injections for trigger finger, first carpometacarpal joint osteoarthritis, and palmar fibromatosis. Part II addresses injections for carpal tunnel syndrome, ganglion cyst, intersection syndrome, triangular fibrocartilage complex injury, and de Quervain tenosynovitis.2

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