Purpose
Although a local corticosteroid injection for carpal tunnel syndrome (CTS) is frequently
performed by palpation using anatomical landmarks, ultrasound (US) allows physicians
to visualize and confirm placement of the injectate close to the median nerve, possibly
improving the efficacy of the injection. The aim of this study was to compare the
effectiveness and complications of US-guided steroid injections with landmark-based
injections for CTS.
Methods
A total of 102 patients with CTS were randomized into 2 groups: landmark-based injection
and US-guided injection. The response to treatment, including grip strength and the
Boston Carpal Tunnel Questionnaires (BCTQ) was assessed at baseline and at 4, 12,
and 24 weeks after the injection.
Results
The BCTQ symptom and function scores were similar in the 2 groups throughout the 24-week
follow-up period, with the exception of significantly lower (better) symptom scores
at 4-week follow-up in the US-guided injection group. The grip strength was similar
in the 2 groups throughout the 24-week follow-up period. After 24 weeks, 12 patients
(24%) in the landmark-based injection group and 9 patients (18%) in the US-guided
injection group had undergone carpal tunnel surgery. Symptoms of median nerve irritation
were more likely to occur in patients with landmark-based injections (14%) than in
those with US-guided injection (2%).
Conclusions
A US-guided steroid injection for CTS produces pain and functional results similar
to those of landmark-based injection.
Type of study/level of evidence
Therapeutic I.
Key words
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Article info
Publication history
Accepted:
February 1,
2019
Received:
July 21,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
