Predictive variables for sonographically guided corticosteroid injection in mild-to-moderate carpal tunnel syndrome

Seong Yun Chung, Jung Min Kwak, Seok Kang, Seong Ho Son, Jae Do Kim, Joon Shik Yoon

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)

    Abstract

    Objective To assess the predictive variables after sonographically guided corticosteroid injection in carpal tunnel syndrome. Methods A prospective, observational study was carried out on 25 wrists of 20 consecutive patients with carpal tunnel syndrome, confirmed by the American Association of Neuromuscular and Electrodiagnostic Medicine criteria, which includes clinical history, symptoms, and evidence of slowing of distal median nerve conduction. Visual analogue scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were asked to the patients before and 4 weeks after the procedure. On a basis of VAS difference before and after the procedure, we divided the patients into two groups: more than 50% of VAS improving (good response group) and less than 50% of VAS improving (poor response group). Also, nerve conduction studies and ultrasound evaluations were performed prior to sonographically guided corticosteroid injection and at 4 weeks after the procedure. The cross-sectional area (CSA) of median nerve at maximal swelling point around wrist was measured by manual tracing using ultrasonography. With assessments mentioned above, we tried to assess predictive variables for prognosis after sonographically guided corticosteroid injection in carpal tunnel syndrome. Results The CSA of median nerve at wrist measured before the procedure was significantly larger in good response group than in poor response group. Furthermore, the CSA of median nerve at wrist, symptom severity scale of BCTQ, motor/sensory latency and sensory amplitude were correlated with VAS improving. Conclusion The CSA of median nerve at wrist is the strongest predictive value for sonographically guided corticosteroid injection in mild-to-moderate carpal tunnel syndrome.

    Original languageEnglish
    Pages (from-to)213-221
    Number of pages9
    JournalAnnals of Rehabilitation Medicine
    Volume42
    Issue number2
    DOIs
    Publication statusPublished - 2018 Apr 1

    Bibliographical note

    Funding Information:
    This work was supported by Electronics and Telecommunications Research Institute (ETRI) grand funded by the Korean government (No. 17ZR1400, Research on Beam Focusing Algorithm for Microwave Treatment).

    Publisher Copyright:
    © 2018 by Korean Academy of Rehabilitation Medicine.

    Keywords

    • Carpal tunnel syndrome
    • Corticosteroids
    • Treatment outcome
    • Ultrasonography

    ASJC Scopus subject areas

    • Rehabilitation

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