title: Effectiveness of Ultrasound-Guided Compared to Blind Steroid Injections in the Treatment of Carpal Tunnel Syndrome.
abstract: 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.
  
  
  
  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.
  
  
  
  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]).
  
  
  
  This study indicates that ultrasound-guided injections are more effective in comparison to blind injections in the treatment of CTS.
authors.affiliation: Mayo Clinic, Rochester, Minnesota, and Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Evers
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bryan
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Sanders
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Russell
authors.initials: R
authors.lastname: Gelfman
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Amadio
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000639:trends
chemical_list: D000305:Adrenal Cortex Hormones