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KMID : 0361420110350030388
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 3 p.388 ~ p.394
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Usefulness of Ultrasonography to Predict Response to Injection Therapy in Carpal Tunnel Syndrome
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Jeong Jin-Seok
Yoon Joon-Shik
Kim Sei-Joo
Park Byung-Kyu
Won Sun-Jae
Cho Jung-Mo
Byun Chan-Woo
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Abstract
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Objective: To verify the feasibility of initial parameters of ultrasonography or electromyography for the prediction of eff ect 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. Th e 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 aff ected wrists were enrolled. After steroid injection therapy, clinical and electromyographic parameters showed signifi cant improvements at 1 month or 6 months after injection, and ultrasonographic parameters showed signifi cant 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 fi rst month after injection and lasted up to 6 months. Th e initial median nerve swelling and its ratio may be a useful predictor of response after steroid injection.
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KEYWORD
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Carpal tunnel syndrome, Ultrasonography, Area ratio, Injection, Predictor
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