Carpal Tunnel Syndrome (CTS)
Conditions
Keywords
Carpal Tunnel Syndrome (CTS), Hyaluronic Acid, Corticosteroid Injection, Ultrasound-Guided Injection, Median Nerve
Brief summary
This study compares the effectiveness of two types of local injections-Hyaluronic Acid (HA) and corticosteroids-for treating mild to moderate idiopathic Carpal Tunnel Syndrome (CTS). Sixty adult patients will be assigned to receive one of the two injections under ultrasound guidance. The goal is to see if HA is as effective as the standard corticosteroid treatment in improving symptoms and nerve function over a 3-month follow-up period.
Detailed description
This is a prospective comparative 3-month follow-up study. Sixty adult patients diagnosed with mild or moderate idiopathic CTS by electro-diagnostic studies will be recruited from the Rheumatology and rehabilitation clinic at Minia University Hospitals, Egypt. Participants will be divided into two groups of 30: one receiving low molecular weight hyaluronic acid and the other receiving corticosteroids, both administered via ultrasound-guided perineural injection. Baseline and follow-up assessments at 1- and 3-months post-injection will include the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores, electro-diagnostic parameters (sensory and motor latencies, CMAP, etc.), and neuromuscular ultrasound examination (median nerve cross-sectional area, flattening ratio, etc.).
Interventions
Ultrasound-guided perineural injection of low molecular weight Hyaluronic Acid.
DRUGcorticosteroid
Ultrasound-guided perineural injection of corticosteroids
Sponsors
Minia University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Numbness or pain in the Median Nerve (MN) distribution. 2. Nerve conduction studies (NCS) consistent with CTS as per the AANEM guidelines. 3. An MN cross-sectional area (CSA) at the wrist \>12 mm²
Exclusion criteria
1. Patients with severe symptoms (indication for surgery). 2. Patients who show improvement on medical treatment. 3. Patients with previous surgical or injectional CTS treatment. 4. Coexistence of brachial plexopathy, or thoracic outlet syndrome. 5. Patients with infection at the site of injection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Scores | Baseline, 1 month, and 3 months post-injection | Comparison of the BCTQ scores (symptom severity and functional status) between the Hyaluronic Acid and Corticosteroid groups. |
| Change in Electro-diagnostic Parameters | Time Frame Baseline, 1 month, and 3 months post-injection | Comparison of sensory and motor electrodiagnostic parameters between the two groups, including peak sensory latency (ms), sensory nerve action potential - SNAP (µV), sensory conduction velocity - SCV (m/s), distal motor latency (ms), compound muscle action potential - CMAP (mV), and motor conduction velocity - MCV (m/s). |
| Change in Neuromuscular Ultrasound Examination Parameters | Baseline, 1 month, and 3 months post-injection | Comparison of neuromuscular ultrasound parameters between the two groups, including the median nerve cross-sectional area (CSA) measured in mm², fascicular pattern, flattening ratio, and mobility of the median nerve. |
Countries
Egypt
Contacts
CONTACTYara Assem Assem, MD
CONTACTHaidy Mohamed Osman, Osman
Outcome results
None listed