title: A Randomized Prospective Comparison of Ultrasound-Guided and Landmark-Guided Steroid Injections for Carpal Tunnel Syndrome.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical and electrodiagnostic efficacy of ultrasound (US)-guided versus landmark (LM)-guided steroid injections in patients with carpal tunnel syndrome (CTS).
  
  
  METHODS
  This randomized clinical trial included 47 patients (60 affected hands) with moderate CTS (30 hands in each group). All clinically suspected patients with CTS who met the inclusion criteria confirmed by electrodiagnostic tests were enrolled. The subjects received 40 mg of methylprednisolone either with the US-guide or the LM-guided injection technique. They were evaluated using the Boston Carpal Tunnel Questionnaire (symptom/function/total) and 6 electrodiagnostic findings at the baseline and 12 weeks after injection.
  
  
  RESULTS
  Symptom severity scores and functional status scores and electrodiagnostic parameters were significantly improved within each group at week 12 after treatment (P < 0.05), except for compound muscle action potential amplitude and motor nerve conduction velocity (P > 0.05). The improvement in symptom severity scores and functional status scores in the US-guided group was more than in the LM-guided group after 12 weeks, but there was no statistically significant difference (P = 0.79 and 0.64). The mean changes in electrodiagnostic parameters were also not different between groups except for the higher sensory nerve action potential amplitude in LM-guided group (P = 0.003).
  
  
  CONCLUSIONS
  Both US-guided and LM-guided steroid injections were effective in reducing the symptoms, improving the function and electrodiagnostic findings of CTS. Although there was better symptomatic improvement with US-guided injections and better increase in sensory nerve action potential amplitude with LM-guided injection, a significant difference was not generally observed between US-guided and LM-guided CTS injections.
authors.affiliation: *Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; †Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran; and ‡Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Eslamian
authors.forename: Bina
authors.initials: B
authors.lastname: Eftekharsadat
authors.forename: Arash
authors.initials: A
authors.lastname: Babaei-Ghazani
authors.forename: Fateme
authors.initials: F
authors.lastname: Jahanjoo
authors.forename: Mojgan
authors.initials: M
authors.lastname: Zeinali
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004568:Electrodiagnosis; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone