Comparison of Ultrasound Findings of Carpal Tunnel Syndrome before and after Corticosteroid Injection

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.

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.

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).

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.