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Corticosteroid injection is a well accepted method of treatment for stenosing tenosynovitis.  Repeated injections are discouraged for reasons including the potential risk of eventual tendon rupture.  Most literature concedes that up to two injections in the same tendon sheath are relatively safe.  Complete rupture of the flexor carpi radialis (FCR) tendon following two or fewer injections was seen in four patients.  The patients were nearly identical in demographic characteristics, males ranging in age from 56-59 years, all sustaining rupture of the right dominant FCR between 6 months and one year following the receipt of 1 or 2 corticosteroid injections into the distal FCR sheath.  The patients did not recognize a distinct, singular rupture event but rather eventually presented with chronic pain during any gripping or wrist extension activity.  The pain and disability declared by the patients appeared out of proportion to the relatively innocuous nature of the pathology with an average pre-operative Disabilities of the Arm, Shoulder, and Hand (DASH) score of 35 (range 23-47).  There was a palpable, tender mass of retracted ruptured FCR tendon 6 cm proximal to the wrist crease as well as a palpable cord of pseudotendon formed within the residual sheath.  Pain along the course of the pseudotendon up to the mass was consistently provoked by wrist extension on examination. All four patients were treated by complete excision of both the ruptured mass of tendon and pseudotendon resulting in complete relief of symptoms, average post-operative DASH score of 3.