Ultrasound-guided dextrose hydrodissection for multiple peripheral entrapment neuropathies in scleroderma: a case presentation

Abstract

Scleroderma, also known as systemic sclerosis, is a rare connective tissue disorder with an unclear and poorly understood pathogenesis. While it primarily affects the skin and internal organs through mechanisms involving vascular dysfunction, immune dysregulation, and fibrosis, its effects on the peripheral nervous system may also be substantial. We report the case of a 36-year-old male with a known history of scleroderma who presented with chronic, diffuse burning pain throughout the body. His symptoms included daily asthenia, dizziness, nausea, headaches, and limb pain exacerbated by cold, compression, or stretching. Diagnostic ultrasound confirmed multiple peripheral nerve entrapments, which were treated with ultrasound-guided 5% dextrose hydrodissection. This intervention provided significant relief of pain, paresthesia, and motor symptoms, which improved his quality of life. This case highlights the potential of dextrose hydrodissection as a safe, minimally invasive, and cost-effective symptomatic treatment for peripheral neuropathies in patients with scleroderma. Further studies are warranted to establish its broader therapeutic role in treating scleroderma-related neuropathies.

Keywords

chronic pain management / ultrasound-guided / dextrose prolotherapy / systemic sclerosis / scleroderma / limb pain

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