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Occipital neuralgia is a chronic headache condition described as paroxysmal, severe, sharp, and shooting type in the dermatome of greater and lesser occipital nerve. The exact cause is not known but could be associated with trauma, entrapment, or inflammation of the occipital nerve. Headache may have been one of the symptoms in multiple sclerosis including the neuralgic form of headache but there is no definite study to say the exact incidence and prevalence of occipital neuralgia in multiple sclerosis. It is very difficult to diagnose occipital neuralgia from various differentials of chronic headaches and the management of the disease is also a complex thing. We report a case of multiple sclerosis with chronic headache with features suggestive of occipital neuralgia. Ultrasound-guided diagnostic right-sided occipital nerve block was done with immediate pain relief followed by ultrasound-guided cryoneurolysis of all three occipital nerves bilaterally. The patient reported significant pain relief. Increasing the use of ultrasonography in pain medicine, ultrasound-guided occipital nerve block could be one of the promising methods for diagnosing and treating occipital headaches. With the use of ultrasonography exact location of the nerves, real-time image of the needle and its advancement could be visualized. This provides the advantage of accurate needle entry into the target tissue with less injury to surrounding tissue. [ABSTRACT FROM AUTHOR]

De Quervain's tenosynovitis (DQT) is degeneration and thickening of tendon sheath of 1st dorsal compartment of the wrist that contains abductor pollicis longus and extensor pollicis brevis tendon. In this case, we have chosen fenestration technique along with hydrodissection of tendon sheath for minimal interventional management. Fenestration technique involves gently passing a needle through the tendon sheath multiple times to and fro movement to change a chronic degenerative process into an acute condition that is more likely to heal. This procedure is done to see the effect of fenestration technique along with hydrodissection in view of pain relief and functional improvement. A 47-year-old female patient with DQT managed with ultrasonography guided fenestration followed by hydrodissection using 5% dextrose. Follow-up was taken after 1 month of procedure. The patient has 70%-80% pain relief quantified with numerical rating scale and 80% functional improvement. [ABSTRACT FROM AUTHOR]