PM&R News   •   September 2018

Continuing with our recent blog posts on the use of ultrasound, lets switch to a procedural approach. For decades, peripheral injections have been performed with landmark guidance. However, as the popularity and quality of ultrasound has been improving, ultrasound guided injections have increased in number. The majority of studies evaluating ultrasound guided injections versus landmark guided injections have shown better accuracy but not necessarily better efficacy, with the exception of a few studies. This study set to look at ultrasound guided vs landmark guided for carpal tunnel corticosteroid injections. The systematic review and meta-analysis of randomized controlled trials reviewed the literature and ultimately included 3 randomized controlled trials. The outcome measures were the symptom severity scale and the functional severity scale, as well as change in compound motor action potential, sensory nerve action potential, distal motor latency, distal sensory latency. Results showed a significant decrease in symptom severity score for ultrasound guided injections, but no significant changes in the other domains. This does show that ultrasound guided injections can be beneficial for carpal tunnel syndrome in decreasing symptoms although overall function seems to be unchanged.