Volume 26, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2020)                   Avicenna J Clin Med 2020, 26(4): 193-198 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Golmohammadi H, Saremi H, Moradi A, Pakmehr S, Esnaashari M. Comparison of Ultrasound Findings of Carpal Tunnel Syndrome before and after Corticosteroid Injection. Avicenna J Clin Med. 2020; 26 (4) :193-198
URL: http://sjh.umsha.ac.ir/article-1-1985-en.html
1- Assistant Professor, Department of Radiology, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
2- Associate Professor, Department of Orthopedic Surgery, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
3- Faculty Member, Department of Community Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4- General Practitioner, Emergency Department, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorram Abad, Iran
5- Radiologist, Department of Radiology, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran , masoudesnaashari@yahoo.com
Abstract:   (533 Views)
Background and Objective: Carpal Tunnel Syndrome is the most prevalent type of peripheral neuropathy due to neural entrapment. This syndrome is primarily diagnosed based on clinical symptoms, and it is subsequently confirmed by electro-diagnostic studies. Ultrasonography as a safe, available, and inexpensive method is also valuable in the follow-up of patients. This study aimed to evaluate the ultrasound findings before and after local corticosteroid injection.
Materials and Methods: This interventional study was conducted on 45 patients referring to the orthopedic clinic of Besat Hospital, Hamadan, Iran, during 2017. The patients who were selected by convenient sampling method had the symptoms of carpal tunnel syndrome and were diagnosed positive based on electrodiagnostic studies indicating a moderate grade of the disease. Wrist ultrasound was performed before and after the injection of corticosteroid (two months later). Moreover, the ultrasound indices were compared before and after the injection. Data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant.
Results: According to the results, 80% of the patients were female. Moreover, the mean age of the patients was 47.9±11.6 years (age range: 22-72 years). About 20% of the cases were left-handed. The right hand was mostly affected by carpal tunnel syndrome (70%). After injection, there were reductions in the median nerve thickness (P=0.95), retinaculum thickness (P=0.001), and nerve cross-sectional area (P=0.001). The Disabilities of the Arm, Shoulder, and Hand (DASH) scale showed that the clinical symptoms of the patients were significantly reduced at the end of the study (P=0.001).
Conclusion: Corticosteroid injection in patients with moderate severity of carpal tunnel syndrome improved the clinical symptoms and caused reductions in median nerve thickness, cross-sectional area, and flexor retinaculum thickness.
Full-Text [PDF 688 kb]   (165 Downloads)    
Type of Study: Original | Subject: Radiology

References
1. Lee JY, Park Y, Park KD, Lee JK, Lim OK. Effectiveness of ultrasound-guided carpal tunnel injection using in-plane ulnar approach: a prospective, randomized, single-blinded study. Medicine (Baltimore). 2014;93(29):e350. PMID: 25546691 DOI: 10.1097/MD.0000000000000350
2. Lee CH, Choi H, Yoon JS, Kang S. Carpal tunnel syndrome assessment with ultrasonography: a comparison between non-diabetic and diabetic patients. Ann Rehabil Med. 2018;42(1):85-91. PMID: 29560328 DOI: 10.5535/arm.2018.42.1.85
3. Abicalaf CA, de Barros N, Sernik RA, Pimentel BF, Braga-Baiak A, Braga L, et al. Ultrasound evaluation of patients with carpal tunnel syndrome before and after endoscopic release of the transverse carpal ligament. Clin Radiol. 2007;62(9):891-4. PMID: 17662738 DOI: 10.1016/j.crad.2007.01.029
4. Maleki N, Azami A, Anari H, Iranparvar Alamdari M. Value of ultrasonography in the diagnosis of carpal tunnel syndrome confirmed by nerve conduction study. Sci J Kurdistan Univ Med Sci. 2014,19(4):58-66. [Persian]
5. Rezazadeh AL, Bakhtiary AH, Samaei AF, Moghimi JA, Ghorbani RA. Diagnostic value of ultrasonography using median nerve-tunnel index in patients with carpal tunnel syndrome. Koomesh. 2014;15(4):530-40. [Persian]
6. Dalili AR, Mardani-kivi M, Alizadeh A, Hatamian HR, Hoseininejad M, Peyrazm H, et al. Comparison between sonography and electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. Anesthesiol Pain. 2011;15(2):43-51. [Persian]
7. Khosrawi S, Emadi M, Mahmoodian AE. Effectiveness of splinting and splinting plus local steroid injection in severe carpal tunnel syndrome: a randomized control clinical trial. Adv Biomed Res. 2016;5:16. PMID: 26962518 DOI: 10.4103/2277-9175.175902
8. Ciftdemir M, Copuroglu C, Ozcan M, Cavdar L. Carpal tunnel syndrome in manual tea harvesters. Eklem Hastalik Cerrahisi. 2013;24(1):12-7. PMID: 23441735 DOI: 10.5606/ehc.2013.04
9. Shannon H, Rizzolo D. Carpal tunnel syndrome: symptoms, diagnosis, and treatment options. JAAPA. 2012;25(9):22-6. PMID: 22991883 DOI: 10.1097/01720610-201209000-00005
10. Jenkins PJ, Srikantharajah D, Duckworth AD, Watts AC, McEachan JE. Carpal tunnel syndrome: the association with occupation at a population level. J Hand Surg Eur Vol. 2013;38(1):67-72. PMID: 22832982 DOI: 10.1177/1753193412455790
11. Soyupek F, Yesildag A, Kutluhan S, Askin A, Ozden A, Uslusoy GA, et al. Determining the effectiveness of various treatment modalities in carpal tunnel syndrome by ultrasonography and comparing ultrasonographic findings with other outcomes. Rheumatol Int. 2012;32(10):3229-34. PMID: 22038192 DOI: 10.1007/s00296-011-2173-7
12. Kaile E, Bland JD. Safety of corticosteroid injection for carpal tunnel syndrome. J Hand Surg Eur Vol. 2018;43(3):296-302. PMID: 29020874 DOI: 10.1177/1753193417734426
13. Murtagh J. Injection of the carpal tunnel. Aust Fam Physician. 1991;20(8):1188. PMID: 1953461
14. Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007;2:CD001554. PMID: 17443508 DOI: 10.1002/14651858.CD001554.pub2
15. Ustün N, Tok F, Yagz AE, Kizil N, Korkmaz I, Karazincir S, et al. Ultrasound-guided vs blind steroid injections in carpal tunnel syndrome: a single-blind randomized prospective study. Am J Phys Med Rehabil. 2013;92(11):999-1004. PMID: 23811617 DOI: 10.1097/PHM.0b013e31829b4d72
16. Chen PC, Wang LY, Pong YP, Hsin YJ, Liaw MY, Chiang CW. Effectiveness of ultrasound-guided vs direct approach corticosteroid injections for carpal tunnel syndrome: A double-blind randomized controlled trial. J Rehabil Med. 2018;50(2):200-8. PMID: 29355292 DOI: 10.2340/16501977-2308
17. Armstrong T, Devor W, Borschel L, Contreras R. Intracarpal steroid injection is safe and effective for short-term management of carpal tunnel syndrome. Muscle Nerve. 2004;29(1):82-8. PMID: 14694502 DOI: 10.1002/mus.10512
18. Evers S, Bryan AJ, Sanders TL, Gunderson T, Gelfman R, Amadio PC. Corticosteroid injections for carpal tunnel syndrome: long-term follow-up in a population-based cohort. Plast Reconstr Surg. 2017;140(2):338-47. PMID: 28746281 DOI: 10.1097/PRS.0000000000003511
19. Wang PH, Tsai CL, Lee JS, Wu KC, Cheng KI, Jou IM. Effects of topical corticosteroids on the sciatic nerve: an experimental study to adduce the safety in treating carpal tunnel syndrome. J Hand Surg Eur Vol. 2011;36(3):236-43. PMID: 21282223 DOI: 10.1177/1753193410390760
20. Roh YH, Noh JH, Gong HS, Baek GH. Comparative study on the effectiveness of a corticosteroid injection for carpal tunnel syndrome in patients with and without Raynaud's phenomenon. Bone Joint J. 2017;99-B(12):1637-42. PMID: 29212687 DOI: 10.1302/0301-620X.99B12.BJJ-2017-0371.R2

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


© 2020 All Rights Reserved | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb