Effectiveness of Ultrasound-Guided Carpal Tunnel Injection Using In-Plane Ulnar Approach A Prospective, Randomized, Single-Blinded Study
- Authors
- Lee, Jin Young; Park, Yongbum; Park, Ki Deok; Lee, Ju Kang; Lim, Oh Kyung
- Issue Date
- Dec-2014
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Citation
- MEDICINE, v.93, no.29
- Journal Title
- MEDICINE
- Volume
- 93
- Number
- 29
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/12087
- DOI
- 10.1097/MD.0000000000000350
- ISSN
- 0025-7974
- Abstract
- The objective of this study is to evaluate the degree of symptom improvement and the change of electrophysiological and ultrasonographic findings after sonographically guided local steroid injection using an in-plane ulnar approach in carpal tunnel syndrome (CTS). Seventy-five cases of 44 patients diagnosed with CTS were included and evaluated at baseline and at 4 and 12 weeks after injection. All patients received injection with 40 mg of triamcinolone mixed with 1 mL of 1% lidocaine into the carpal tunnel using an in-plane Ultrasound (US)guided ulnar approach, out-plane US-guided approach, and blind injection. For clinical evaluation, we used the Boston Carpal Tunnel Questionnaire (BCTQ) and electrophysiological tests. The ultrasonographic findings were also evaluated with regard to cross-sectional area and the flattening ratio of the median nerve. Subjective symptoms measured by BCTQ and median nerve conduction parameters showed significant improvement at 4 weeks in the in-plane ulnar approach group compared with the out-plane ulnar approach and blind injection. This improvement was still observed at 12 weeks. The flattening ratio and cross-sectional area of the median nerve showed a more significant decrease with the in-plane ulnar approach than with the out-plane ulnar approach and blind injection (P < 0.05). US-guided local steroid injection using an in-plane ulnar approach in the CTS may be more effective than out-plane or blind injection.
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