Effectiveness of Ultrasound-Guided Compared to Blind Steroid Injections in the Treatment of Carpal Tunnel Syndrome

Arthritis Care Res (Hoboken). 2017 Jul;69(7):1060-1065. doi: 10.1002/acr.23108. Epub 2017 Jun 8.

Abstract

Objective: To compare the effectiveness of ultrasound-guided injections to blind injections in the treatment of carpal tunnel syndrome (CTS) in a large community-based cohort.

Methods: This study evaluated residents of Olmsted County, Minnesota, treated with a corticosteroid injection for CTS between 2001 and 2010. The proportion of patients receiving retreatment and the duration of retreatment-free survival between blind and ultrasound-guided injections were compared. Propensity score matching was used to control for confounding by indication.

Results: In the matched data set consisting of 234 (of 600) hands treated with a blind injection and 87 (of 89) ultrasound-guided injection cases, ultrasound guidance was associated with a reduced hazard of retreatment (hazard ratio 0.59 [95% confidence interval (95% CI) 0.37-0.93]). In addition, ultrasound guidance was associated with 55% reduced odds of retreatment within 1 year compared to blind injections (adjusted odds ratio 0.45 [95% CI 0.24-0.83]).

Conclusion: This study indicates that ultrasound-guided injections are more effective in comparison to blind injections in the treatment of CTS.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Aged
  • Carpal Tunnel Syndrome / diagnostic imaging*
  • Carpal Tunnel Syndrome / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*
  • Ultrasonography, Interventional / trends

Substances

  • Adrenal Cortex Hormones