Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study.
10.5535/arm.2015.39.2.176
- Author:
Chang Kweon CHOI
1
;
Hyun Seok LEE
;
Jae Yeoun KWON
;
Won Jae LEE
Author Information
1. Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea. braddom@nate.com
- Publication Type:Original Article
- Keywords:
Cubital tunnel syndrome;
Ulnar nerve;
Neural conduction;
Ultrasonography;
Injections
- MeSH:
Classification;
Cubital Tunnel Syndrome;
Elbow*;
Humans;
Lidocaine;
Neural Conduction;
Pilot Projects*;
Triamcinolone;
Ulnar Nerve;
Ulnar Neuropathies*;
Ultrasonography;
Visual Analog Scale;
Surveys and Questionnaires
- From:Annals of Rehabilitation Medicine
2015;39(2):176-182
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes. METHODS: A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by an electrodiagnostic study, participated in this study. US-guided injection into the cubital tunnel was performed with 40 mg triamcinolone and 2 mL of 1% lidocaine. Outcomes of the injections were evaluated at pre-injection, 1st week and 4th week after injection. Visual analog scale, self-administered questionnaire of the ulnar neuropathy at the elbow (SQUNE), and McGowan classification were used for clinical evaluation. Cross-sectional area of the ulnar nerve by US and the electrophysiological severity scale through a nerve conduction study were utilized in the evaluation of morphologic and electrophysiological changes. The cross-sectional area of the ulnar nerve was measured at 3 points of condylar, proximal, and distal level of the cubital tunnel. RESULTS: No side effects were reported during the study period. The visual analog scale and cross-sectional area showed a significant decrease at 1st week and 4th week, as compared to baseline (p<0.05). The electrophysiological severity scale was significantly decreased at the 4th week, as compared with baseline and 1st week (p<0.05). Among the quantitative components of the scale, there were statistically significant improvements with respect to the conduction velocity and block. CONCLUSION: The new approach of US-guided injection may be a safe tool for the treatment of CuTS. Symptomatic and morphologic recoveries preceded the electrophysiological improvement.
