Ultrasonographic changes after steroid injection in carpal tunnel syndrome

Lee, Yeon Soo; Choi, Eunseok

doi:10.1007/s00256-017-2738-y

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…found decreased median nerve CSA (from 13.76 to 11.77 mm 2 ) at the CSA‐I in 13 patients (13 wrists) 4 weeks after a single injection of 20 mg triamcinolone. In a recent study of 18 patients (27 wrists) with CTS, Lee et al . found decreased median nerve CSA in the proximal carpal tunnel (from 10.51 to 6.60 mm 2 ) 8 weeks after a single injection of 40 mg triamcinolone.…”

Section: Discussionmentioning

confidence: 95%

“…Despite the well‐established effectiveness of steroid injections for CTS, the extent to which sonographic measurements change after local steroid injection is not well understood. Only a few studies have evaluated structural changes in the median nerve after local steroid injection, and the evidence is insufficient to conclude that injections reduce median nerve CSA . Some of these studies were limited by their small samples, and some have analyzed 2 hands from the same patient, which raises potential statistical bias caused by including both between‐subject and within‐subject data.…”

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confidence: 99%

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Sonographic median nerve change after steroid injection for carpal tunnel syndrome

et al. 2018

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Sonographic median nerve change after steroid injection for carpal tunnel syndrome

et al. 2018

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“…Ultrasound provides clear anatomic landmarks for steroids injections as part of the treatment for entrapment neuropathies; 120 in addition, it can be used to determine the clinical response to treatment. Lee et al found a significant reduction in the median nerve CSA starting 1-week post injection for CTS; changes in ultrasound parameters correlated with patient-reported improvement in pain scores 121 …”

Section: Practical Uses Of Nerve Ultrasoundmentioning

confidence: 97%

“…Lee et al found a significant reduction in the median nerve CSA starting 1-week post injection for CTS; changes in ultrasound parameters correlated with patient-reported improvement in pain scores. 121…”

Section: Injections For Entrapment Neuropathiesmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.

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“…Schrier et al showed the association between median nerve mobility and symptom severity at 3 months post-surgery [ 5 ]. Another study found significant negative correlation between the transverse sliding distance of median nerve and pain score after steroid intervention [ 28 ]. These results allowed us to monitor therapeutic effect not only with subjective pain score, but also nerve mobility to provide further morphological evidence after injection.…”

Section: Discussionmentioning

confidence: 99%

Effect of Perineural Injection with Different Dextrose Volumes on Median Nerve Size, Elasticity and Mobility in Hands with Carpal Tunnel Syndrome

et al. 2021

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This study aimed to investigate the effect of different injectate volumes on ultrasonographic parameters and the correlation to clinical outcomes under perineural dextrose injection (PDI). In this post hoc analysis of the randomized, double-blinded, three-arm trial, ultrasound-guided PDI with either 1 mL, 2 mL, and 4 mL 5% dextrose water was administered, respectively, in 14, 14, and 17 patients. Ultrasound outcomes included mobility, shear-wave elastography (SWE), and cross-sectional area (CSA) of the median nerve; clinical outcomes were Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) score. Outcomes were measured before injection, and after injection at the 1st, 4th, 12th, and 24th week. For ultrasound outcomes, CSA decreased significantly from baseline data at all follow-up time-points in the 2 mL group (p = 0.005) and the 4 mL group (p = 0.015). The mean change of mobility from baseline showed a greater improvement on the 4 mL group than the other groups at the 1st week post-injection. For clinical outcomes, negative correlation between the VAS and mobility at the 1st (p = 0.046) and 4th week (p = 0.031) post-injection in the 4 mL group were observed. In conclusion, PDI with higher volume yielded better nerve mobility and decreased CSA of median nerve, but no changes of nerve elasticity.

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Ultrasonographic changes after steroid injection in carpal tunnel syndrome

Cited by 8 publications

References 38 publications

Sonographic median nerve change after steroid injection for carpal tunnel syndrome

Sonographic median nerve change after steroid injection for carpal tunnel syndrome

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Effect of Perineural Injection with Different Dextrose Volumes on Median Nerve Size, Elasticity and Mobility in Hands with Carpal Tunnel Syndrome

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