gms | German Medical Science

Objectives/Interrogation: Although a local corticosteroid injection for carpal tunnel syndrome (CTS) is frequently performed by palpation using anatomic landmarks, ultrasound allows physicians to place the injectate closer to the median nerve without damaging the surrounding tissue, improving the efficacy of the injection. The aim of this study was to compare the effectiveness and complications of ultrasound (US)-guided steroid injections with blind injections for CTS.

Methods: A total of 102 patients with CTS were randomized into 2 groups: blind injection and US-guided injection. The response to treatment, including grip strength, perception of touch with a Semmes-Weinstein monofilament, and the Boston Carpal Tunnel Questionnaires (BCTQ) was assessed at baseline and at four, 12, and 24 weeks after the injection (Figure 1 [Fig. 1]).

Results and Conclusions: The Boston symptom and function scores were similar in the two groups throughout the 24 week follow-up period, with the exception of significantly lower (better) Boston symptom scores at 4 week follow-up in the US-guided injection group than in the blind group. The grip strength and sensory index of Semmes-Weinstein monofilament were similar in the two groups throughout the 24 week follow-up period. After 24 weeks, 12 patients (24%) in the blind injection group and 9 patients (18%) in the US-guided injection group had undergone carpal tunnel surgery. With regard to adverse events, symptoms of median nerve irritation were more likely to occur in patients with blind injections than in those with US-guided injection (14% vs. 2%). US-guided steroid injection for CTS reduces steroid-associated complications, but produces similar pain and functional results to those of blind injection.