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To the Editor:—
I would like to make the following observations about the lady in whom vascular compromise developed after injection of dexamethasone for a painful wrist ( Intra-Articular Injection," QUESTIONS AND ANSWERS, JAMA189:1040 [Sept 28] 1964).First, the primary condition would appear to be de Quervain's disease, though the exact term is not used. This condition occurs more frequently in females than in males.Second, the respondent discusses intra-articular injection while the questioner discusses a non-articular injection into the soft tissues about the radial styloid. If one injected slightly anterior to the abductor tendon, the injection could have gone into the radial artery. Again, the questioner does not state if he gave the injection toward the elbow or distally. This makes a difference in the possible anatomy about the needle point.Third, the aspiration of blood prior to any injection is no absolute criterion for a nonvascular injection.
Cooper JW. Radial-Artery Compromise Following Injection. JAMA. 1965;191(9):766. doi:10.1001/jama.1965.03080090080032
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