Carpal Tunnel Syndrome
Conditions
Keywords
carpal tunnel syndrome
Brief summary
The objective of this study was to assess sonographic changes of the median nerve after steroid injection for carpal tunnel syndrome.
Detailed description
Patients with CTS were recruited. The Boston Questionnaire (BQ) was administered and ultrasonographic and electrophysiological examinations were performed before and at two, six, and 12 weeks after steroid injection. Cross sectional area (CSA) was measured at 2 levels: at the tunnel inlet and in the mid-carpal tunnel. Flattening ratio (FR) was measured only in the mid-carpal tunnel. Correlation analyses between baseline ultrasonography, BQ, and electrophysiological measures were performed.
Interventions
ultrasound-guided steroid injection using 1ml of 10 mg (10mg/ml) triamcinolone acetonide
Sponsors
Taipei Veterans General Hospital, Taiwan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
All patients received steroid injection for carpel tunnel syndrome (CTS) and ultrasonographic evaluation before and after steroid injection
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. clinical diagnosis of CTS 2. The diagnosis of CTS was confirmed by electrophysiological tests.
Exclusion criteria
1. neurologic disorders that could mimic CTS such as cervical radiculopathy, polyneuropathy, proximal median nerve entrapment, or thoracic outlet syndrome 2. history of distal radius fracture 3. pregnancy or lactation 4. regular use of systemic NSAIDs or corticosteroids 5. known allergy to corticosteroids and local anesthetics.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cross sectional area | 12 weeks | The CSA of the median nerve was measured at 2 levels: at the carpal tunnel inlet (CSA-I; immediately prior to the proximal margin of the flexor retinaculum) and in the mid-carpal tunnel (CSA-M; at the level of the pisiform bone and scaphoid tubercle) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Boston Carpal Tunnel Questionnaire (BQ) | 2, 6, 12 weeks | The BQ was interviewed-administered to assess the severity of symptoms and functional status. |
| Median nerve distal motor latency | 2, 6, 12 weeks | the CMAPs were obtained via surface electrodes placed on the abductor pollicis brevis muscle. The active recording electrode was placed on the muscle belly, and the reference electrode was placed on the tendon insertion. The median nerve was stimulated 8 cm proximal to the active recording electrode. Distal motor latencies were measured from the onset of stimulus artifact to the onset of the CMAP |
| flattening ratio | 2, 6, 12 weeks | The flattening ratio was measured only at the mid-tunnel (FR-M). FR was calculated by dividing the horizontal diameter of the nerve by the vertical diameter. |
| compound muscle action potential amplitude (CMAP) | 2, 6, 12 weeks | the CMAPs were obtained via surface electrodes placed on the abductor pollicis brevis muscle. The active recording electrode was placed on the muscle belly, and the reference electrode was placed on the tendon insertion. The median nerve was stimulated 8 cm proximal to the active recording electrode. The amplitude of CMAP were measured from baseline to negative peak. |
| sensory nerve action potential amplitudes. | 2, 6, 12 weeks | SNAPs were obtained using an antidromic method and recorded by surface electrodes placed at the proximal and distal interphalangeal joints of the index finger for the median nerve and the same joints of the little finger for the ulnar nerve. The median nerves were stimulated at the wrist at a distance of 14 cm from the wrist to the active electrode. The amplitude of SNAP were measured from baseline to negative peak. |
| sensory nerve conduction velocity | 2, 6, 12 weeks | SNAPs were obtained using an antidromic method and recorded by surface electrodes placed at the proximal and distal interphalangeal joints of the index finger for the median nerve and the same joints of the little finger for the ulnar nerve. The median nerves were stimulated at the wrist at a distance of 14 cm from the wrist to the active electrode. Distal sensory latencies were measured from the onset of the stimulus artifact to the onset of the SNAP. SNCV was calculated dividing the distance of 14 cm by the distal sensory latency. |
Countries
Taiwan
Contacts
Primary ContactJia chi Wang, MD
Outcome results
None listed