• Carpal tunnel syndrome
• median nerve
• treatment outcome
• ultrasonography interventional

• Carpal Tunnel Syndrome/therapy
• Humans
• Ultrasonography, Interventional/methods
• Ultrasonography/methods
• Treatment Outcome

• Carpal tunnel
• Outpatient
• POCUS
• Plantar fasciitis
• Primary care
• Sinus
• Ultrasound

• Humans
• Point-of-Care Systems
• Ultrasonography/methods
• Ambulatory Care/methods
• Primary Health Care
• Outpatients

• Carpal tunnel syndrome
• Injection approach
• Injection pain
• Rehabilitation
• Side effect
• Ultrasound-guided

• Humans
• Carpal Tunnel Syndrome
• Male
• Female
• Middle Aged
• Ultrasonography, Interventional
• Pain Measurement
• Injections, Intra-Articular
• Median Nerve/diagnostic imaging
• Adult
• Single-Blind Method
• Aged
• Severity of Illness Index
• Pain/etiology
• Anesthetics, Local/administration & dosage
• Anesthetics, Local/adverse effects

• Humans
• Carpal Tunnel Syndrome/drug therapy
• Glucocorticoids/administration & dosage
• Glucocorticoids/adverse effects
• Injections, Intra-Articular
• Practice Patterns, Physicians'/statistics & numerical data

• approach
• carpal tunnel syndrome
• injection
• patient comfort
• position
• ultrasound-guided

• Humans
• Patient Preference
• Carpal Tunnel Syndrome/diagnostic imaging
• Carpal Tunnel Syndrome/drug therapy
• Ultrasonography
• Pain
• Ultrasonography, Interventional

• boston carpal tunnel questionnaire
• carpal tunnel syndrome
• corticosteroid injection
• cts management
• cts splint
• entrapment neuropathy
• splint
• triamcinolone

• Humans
• Carpal Tunnel Syndrome/diagnostic imaging
• Carpal Tunnel Syndrome/surgery
• Ultrasonography, Interventional
• Median Nerve/diagnostic imaging
• Median Nerve/surgery
• Ultrasonography
• Wrist Joint

• Department of Education of Zhejiang Province

• adult
• humans
• adrenal cortex hormones
• adrenal cortex hormones/adverse effects
• carpal tunnel syndrome
• carpal tunnel syndrome/drug therapy
• hand
• randomized controlled trials as topic

• Adult
• Humans
• Adrenal Cortex Hormones/adverse effects
• Carpal Tunnel Syndrome/drug therapy
• Hand
• Randomized Controlled Trials as Topic

• Median nerve
• carpal tunnel syndrome
• dextrose
• entrapment neuropathy
• injection
• steroid

• Carpal tunnel syndrome
• cross-sectional area
• median nerve
• sonography
• steroid injection

• Humans
• Median Nerve/diagnostic imaging
• Median Nerve/surgery
• Carpal Tunnel Syndrome/diagnostic imaging
• Carpal Tunnel Syndrome/drug therapy
• Carpal Tunnel Syndrome/surgery
• Prognosis
• Retrospective Studies
• Ultrasonography
• Steroids/therapeutic use

• Carpal tunnel syndrome
• Conservative management
• Corticosteroid injection
• In-plane ultrasound
• Out-plane ultrasound

Background: Recently, there was a series of clinical studies focusing on local injection of platelet-rich plasma (PRP) for treatment of patients with carpal tunnel syndrome (CTS). However, the safety and efficacy of PRP in these CTS patients remains controversial. Therefore, we performed a systematic review to compare PRP with other conservative treatments in treatment of CTS patients.

Methods: We systematically searched from electronic databases (Cochrane, PubMed, Web of Science, and EMBASE) up to 10 December 2021. The data of clinical results were extracted and analyzed by RevMan Manager 5.4.

Results: Finally, eight randomized controlled studies, involving 220 CTS patients undergoing local injection of PRP were enrolled in this systematic review. All enrolled trials were considered to be of high quality. In the short-term efficacy, the PRP group was significantly lower in symptom severity scale (SSS) compared with the control group (MD = −2.00; 95% CI, −3.15 to −0.85; p = 0.0007; I² = 0%). In the mid-term efficacy, the PRP group was significantly effective than the control group in the visual analogue scale (MD = −0.63; 95% CI, −1.22 to −0.04; p = 0.04; I² = 61%), SSS (MD = −3.56; 95% CI, −4.93 to −2.18; p < 0.00001; I² = 0%), functional status scale (MD = −2.29; 95% CI, −3.03 to −1.56; p < 0.00001; I² = 45%), sensory peak latency (MD = −0.39; 95% CI, −0.58 to −0.19; p = 0.0001; I² = 0%) and cross-sectional area of median nerve (MD = -0.20; 95% CI, −0.31 to −0.10; p = 0.0002; I² = 0%). In the mid-long-term efficacy, the PRP group was only significantly lower in SSS compared with the control group (MD = −2.71; 95% CI, −4.33 to −1.10; p = 0.001; I² = 38%).

Conclusion: Local PRP injection is more effective than other conservative treatments in terms of mid-term efficacy in relieving pain, improving wrist function and symptoms, reducing MN swelling, and partially improving electrophysiological indicators. However, the long-term adverse side and consensus on standardization of PRP in CTS patients still need further large-scale trials.

• carpal tunnel syndrome
• local injection
• platelet-rich plasma
• steroid
• systematic review

• Adrenal Cortex Hormones/adverse effects
• Carpal Tunnel Syndrome/diagnostic imaging
• Carpal Tunnel Syndrome/drug therapy
• Carpal Tunnel Syndrome/surgery
• Humans
• Median Nerve/diagnostic imaging
• Median Nerve/surgery
• Ultrasonography
• Ultrasonography, Interventional

Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, can, in fact, be considered as a socio-economic issue that reduces work productivity, increases disability, and requires prolonged rehabilitation. The imaging modality of choice in CTS imaging is the ultrasound (US), as several morphological parameters can be used in CTS diagnosis and follow-up. In recent years, US-guided CTS injection therapy has become an established treatment option for mild to moderate CTS. The authors of this review performed a literature search that revealed several differences in US-guided carpal tunnel injection in an attempt to unify individual stages of CTS injections protocol for future guidance: patient preparation, injection approach, needle positioning, injected medications, and injectate volume. The three approaches to carpal tunnel injections described in the literature, that is, the ulnar, radial, and longitudinal, can be implemented with single or multiple deposits and different injection volumes. Medications used for injections are corticosteroids, local anaesthetics, dextrose, saline, platelet-rich plasma, and progesterone.

Although no consensus has yet been reached as to which protocol should be used, the ulnar approach with a single deposit injected in large volumes should be considered as the first choice, while dextrose should be the first-line medication option. Furthermore, as terminological differences make it difficult to draw a uniform comparison the presented steps for US-guided carpal tunnel injection might serve as a guideline for future studies.

• carpal tunnel syndrome
• corticosteroid
• injection approach
• local anaesthetics
• needle positioning
• ultrasound-guided injections

• Carpal tunnel syndrome
• Corticosteroid injection
• Median nerve
• Pulsed radiofrequency
• Ultrasound-guided injection

• MRI
• arthritis
• autoimmune diseases
• health care
• outcome assessment
• ultrasonography

Current non-surgical treatment for peripheral entrapment neuropathy is considered insignificant and unsustainable; thus, it is essential to find an alternative novel treatment. The technique of perineural injection therapy using 5% dextrose water has been progressively used to treat many peripheral entrapment neuropathies and has been proven to have outstanding effects in a few high-quality studies. Currently, the twentieth edition of Harrison’s Principles of Internal Medicine textbook recommends this novel injection therapy as an alternative local treatment for carpal tunnel syndrome (CTS). Hence, this novel approach has become the mainstream method for treating CTS, and other studies have revealed its clinical benefit for other peripheral entrapment neuropathies. In this narrative review, we aimed to provide an insight into this treatment method and summarize the current studies on cases of peripheral entrapment neuropathy treated by this method.

• 5% dextrose
• carpal tunnel syndrome
• entrapment nerve
• hydrodissection
• ultrasound-guided

• carpal tunnel syndrome
• injection
• median nerve
• triamcinolone acetonide
• ultrasound-guided hydrodissection

Ultrasound is clinically used for diagnosis and interventions for musculoskeletal injuries like muscle contusion, but contrast of ultrasonography still remains a challenge in the field of the musculoskeletal system. A level of hydrogen peroxide (H₂O₂) is known to be elevated during mechanical tissue damage and therefore H₂O₂ can be exploited as a diagnostic and therapeutic marker for mechanical injuries in the musculoskeletal system. We previously developed poly(vanillin-oxalate) (PVO) as an inflammation-responsive polymeric prodrug of vanillin, which is designed to rapidly respond to H₂O₂ and exert antioxidant and anti-inflammatory activities. The primary aim of this study is to verify whether PVO nanoparticles could serve as contrast agents as well as therapeutic agents for musculoskeletal injuries simultaneously. In a rat model of contusion-induced muscle injury, PVO nanoparticles generated CO₂ bubbles to enhance the ultrasound contrast in the injury site. A single intramuscular injection of PVO nanoparticles also suppressed contusion-induced muscle damages by inhibiting the expression of pro-inflammatory cytokines and inflammatory cell infiltration. We, therefore, anticipate that PVO nanoparticles have great translational potential as not only ultrasound imaging agents but also therapeutic agents for the musculoskeletal disorders such as contusion.

• inflammation
• musculoskeletal injury
• polymer nanoparticles
• ultrasound imaging
• vanillin

• Meta-analysis
• carpal tunnel syndrome
• local corticosteroid injection
• ultrasound-guided

Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. A search of the PubMed, Cochrane Library, and Embase databases was performed from the date of their inception to October 7, 2020 to identify randomized controlled trials (RCTs). Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results than landmark-guided injection for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD =  − 0.43, 95% CI (− 0.68, − 0.19), P = 0.0005] and Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD =  − 0.50, 95% CI (− 0.84, − 0.15), P = 0.005]. Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

• Carpal tunnel syndrome
• conservative treatment
• randomized controlled trial

• Adrenal Cortex Hormones/therapeutic use
• Boston
• Carpal Tunnel Syndrome/drug therapy
• Humans
• Orthotic Devices
• Treatment Outcome
• Wrist Joint

• Carpal tunnel syndrome
• Platelet-rich plasma
• Rehabilitation

• Carpal tunnel syndrome
• hydrodissection
• long-axis
• short-axis

• Carpal tunnel syndrome
• Randomized controlled trial
• Rehabilitation
• Triamcinolone acetonide

To compare two common approaches for ultrasonography (US)-guided injection.

Sixty patients with mild-to-moderate CTS were included in this double-blind randomized controlled trial (RCT). They received a single shot of corticosteroid injection through either the US-guided in-plane approach: radial or ulnar side. Participants were evaluated using Boston Carpal Tunnel Questionnaire (BCTQ) and visual analogue scale (VAS) for pain, as well as electrodiagnosis (EDX) and US parameters before the intervention, and within 12 weeks of follow-up.

In both groups, all outcomes, except for the electrodiagnostic measures, significantly improved within the follow-up. Pain-VAS and both subscales of BCTQ questionnaire, as our main subjective outcomes, revealed dramatic improvement, with the largest amount of changes in VAS (70%; comparing to baseline value), and about 37% for both of BQSS and BQFS scales, all indicating superiority of radial to ulnar in-plane approach. During the first follow-up, we did not detect any remarkable preference between the groups in either subjective or electrodiagnostic variables. However, there was a significant difference at next follow-up time-points in terms of VAS for pain and BQFS favoring radial approach (Table 3). Furthermore, US-measured parameters including nerve-circumference and CSA improved only in the radial in-plane group.

The current data proved that radial in-plane approach for CTS injection could be at least as effective as the more common ulnar in-plane method. Even the pain-relief effect was longer for the radial in-plane approach. Also, patients’ functional status and objective variables all revealed better outcomes via the new approach.

• BCTQ
• Boston Carpal Tunnel Questionnaire
• CTS
• carpal tunnel syndrome
• corticosteroid injection
• electromyography

• Injections; Steroids
• Peripheral nerves
• Radiology, interventional
• Ultrasonography

• Carpal Tunnel Syndrome/diagnosis
• Carpal Tunnel Syndrome/surgery
• Consensus
• Delphi Technique
• Humans
• Peripheral Nerves/diagnostic imaging
• Peripheral Nerves/surgery
• Radiography
• Radiology
• Societies, Medical
• Surgery, Computer-Assisted/methods
• Ultrasonography/methods
• Upper Extremity/diagnostic imaging
• Upper Extremity/innervation

• A1 pulley
• Trigger finger
• corticosteroid injection
• ultrasound

• Adrenal Cortex Hormones/administration & dosage
• Adrenal Cortex Hormones/therapeutic use
• Aged
• Female
• Fingers/diagnostic imaging
• Fingers/surgery
• Humans
• Injections
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Trigger Finger Disorder/diagnostic imaging
• Trigger Finger Disorder/drug therapy
• Trigger Finger Disorder/surgery
• Ultrasonography, Interventional/methods

The present article has investigated the added value of ultrasound (US) guidance on improving the efficacy of local triamcinolone injection via comparing two US-guided methods versus a conventional landmark-guided approach.

Eighty-one subjects with mild or moderate CTS were included and randomly assigned into three categories including landmark-guided, conventional US-guided midline approach and US-guided ulnar in-plane method. Primarily, participants in the three groups were relatively similar in terms of demographics and their clinical variables comprising visual analog scale (VAS) for pain, pain-free grip strength (PFGS), Boston CTS questionnaire (BCTQ), EDX parameters, and cross-sectional area (CSA) of median nerve measured by ultrasonography. Ten weeks after injection, the changes of clinical and para-clinical outcomes were reassessed for 76 patients who finished the study.

Our findings showed that all three injection methods were associated with a significant and relatively similar improvement in clinical and electrodiagnostic parameters. The post-injection evaluation showed a statistically significant change in all variables except for symptom severity score (SSS) of BCTQ. The best effect-size values were observed for VAS [56%] and functional severity scale (FSS) of BCTQ [42%], both reported in the US-guided midline group. However, no significant difference was found between the groups regarding their improvement in any of the outcome variables (P value >0.05).

Based on the current data, all three injection methods were effective in improving electrodiagnostic findings and clinical symptoms of CTS. Although all approaches were relatively similar, US-guided midline approach was associated with slightly better outcomes.

• conservative treatment
• corticosteroid injection
• electrodiagnosis

• Carpal tunnel syndrome
• complications
• corticosteroid injection
• effectiveness
• ultrasound-guided injection

Carpal tunnel syndrome (CTS) is one of the most common nerve entrapment syndromes, which has a serious impact on patients' work and life. The most effective conservative treatment is steroid injection but its long-term efficacy is still not satisfactory. The aim of this study was to evaluate the effectiveness of steroid injection combined with miniscalpel-needle (MSN) release for treatment of CTS under ultrasound guidance versus steroid injection alone. We hypothesized that combined therapy could be more beneficial.

Fifty-one patients with CTS were randomly allocated into two groups, namely, steroid injection combined with MSN release group and steroid injection group. The therapeutic effectiveness was evaluated using Boston Carpal Tunnel Questionnaire (BCTQ), cross-sectional area (CSA) of the median nerve, and four electrophysiological parameters, including distal motor latency (DML), compound muscle action potential (CMAP), sensory nerve action potential (SNAP), and sensory nerve conduction velocity (SNCV) at baseline, 4 and 12 weeks after treatment.

Compared with baseline, all the parameters in both groups showed statistically significant improvement at week 4 and week 12 follow-up, respectively (P<0.05). When compared with steroid injection group, the outcomes including BCTQ, DML, CMAP, SNCV, and CSA of the median nerve were significantly better in steroid injection combined with MSN release group at week 12 after treatment (P<0.05).

The effectiveness of steroid injection combined with MSN release for CTS is superior to that of steroid injection alone, which may have important implications for future clinical practice. This Chinese clinical trial is registered with ChiCTR1800014530.

• Bursitis
• Compound betamethasone mixture
• Olecranon subcutaneous bursae
• Ultrasound-guided

• Adult
• Aged
• Betamethasone/administration & dosage
• Biopsy, Needle
• Bursa, Synovial/diagnostic imaging
• Bursa, Synovial/drug effects
• Bursa, Synovial/pathology
• Bursitis/diagnostic imaging
• Bursitis/drug therapy
• Bursitis/pathology
• Female
• Humans
• Injections, Intra-Articular
• Male
• Middle Aged
• Olecranon Process
• Treatment Outcome
• Ultrasonography, Interventional

• carpal tunnel syndrome
• corticosteroids
• injection
• sonography
• wrist

• Carpal tunnel syndrome
• Corticosteriods
• Drugs
• Medication
• Rehabilitation
• Review [publication type]
• Treatment outcome

• Carpal tunnel syndrome
• ultrasound-guided
• blind
• injection
• corticosteroid

• Adrenal Cortex Hormones/administration & dosage
• Aged
• Carpal Tunnel Syndrome/diagnostic imaging
• Carpal Tunnel Syndrome/drug therapy
• Carpal Tunnel Syndrome/physiopathology
• Female
• Glucocorticoids/administration & dosage
• Humans
• Injections, Intra-Articular/methods
• Male
• Middle Aged
• Prospective Studies
• Recovery of Function
• Treatment Outcome
• Ultrasonography, Interventional

• De Quervain
• carpal tunnel
• radiocarpal
• thumb carpometacarpal

• Carpal tunnel syndrome
• Conservative treatment
• Injections
• Meta-analysis [publication type]
• Rehabilitation
• Review [publication type]
• Ultrasonography