Usefulness of Ultrasonography to Predict Response to Injection Therapy in Carpal Tunnel Syndrome.
10.5535/arm.2011.35.3.388
- Author:
Jin Seok JEONG
1
;
Joon Shik YOON
;
Sei Joo KIM
;
Byung Kyu PARK
;
Sun Jae WON
;
Jung Mo CHO
;
Chan Woo BYUN
Author Information
1. Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul 152-703, Korea. rehab46@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Carpal tunnel syndrome;
Ultrasonography;
Area ratio;
Injection;
Predictor
- MeSH:
Boston;
Carpal Tunnel Syndrome;
Electromyography;
Female;
Humans;
Median Nerve;
Neural Conduction;
Self-Assessment;
Wrist;
Surveys and Questionnaires
- From:Annals of Rehabilitation Medicine
2011;35(3):388-394
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To verify the feasibility of initial parameters of ultrasonography or electromyography for the prediction of effect after steroid injection therapy in a carpal tunnel syndrome (CTS) patient. METHOD: We recruited individuals with clinical and electrodiagnostic evidence of CTS. Results from the Boston self-assessment questionnaire, median motor and sensory nerve conduction studies, and median nerve ultrasonography were evaluated at baseline, 1 month, and 6 months after injection. Evaluation of median nerve ultrasonography parameters included measurements taken at the maximal swelling point (MS), 2 cm proximal from MS (2MS), and 12 cm proximal from MS (12MS), and its ratio (MS/12MS, 2MS/12MS) was calculated. The correlation between improvement of the symptom score after treatment and baseline parameters was estimated. RESULTS: Fourteen individuals (14 women, mean age 53.8 years) with 22 affected wrists were enrolled. After steroid injection therapy, clinical and electromyographic parameters showed significant improvements at 1 month or 6 months after injection, and ultrasonographic parameters showed significant changes in maximal area and area ratio (MS/12MS) of the median nerve. Symptom score improvement showed a positive correlation in the initial 2MS and ratio of 2MS/12MS after 6 months (p<0.05). CONCLUSION: Most of the improvements occurred during the first month after injection and lasted up to 6 months. The initial median nerve swelling and its ratio may be a useful predictor of response after steroid injection.
