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Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study

OBJECTIVE: To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes. METHODS: A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by...

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Autores principales: Choi, Chang Kweon, Lee, Hyun Seok, Kwon, Jae Yeoun, Lee, Won-Jae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Academy of Rehabilitation Medicine 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414963/
https://www.ncbi.nlm.nih.gov/pubmed/25932413
http://dx.doi.org/10.5535/arm.2015.39.2.176
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author Choi, Chang Kweon
Lee, Hyun Seok
Kwon, Jae Yeoun
Lee, Won-Jae
author_facet Choi, Chang Kweon
Lee, Hyun Seok
Kwon, Jae Yeoun
Lee, Won-Jae
author_sort Choi, Chang Kweon
collection PubMed
description OBJECTIVE: To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes. METHODS: A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by an electrodiagnostic study, participated in this study. US-guided injection into the cubital tunnel was performed with 40 mg triamcinolone and 2 mL of 1% lidocaine. Outcomes of the injections were evaluated at pre-injection, 1st week and 4th week after injection. Visual analog scale, self-administered questionnaire of the ulnar neuropathy at the elbow (SQUNE), and McGowan classification were used for clinical evaluation. Cross-sectional area of the ulnar nerve by US and the electrophysiological severity scale through a nerve conduction study were utilized in the evaluation of morphologic and electrophysiological changes. The cross-sectional area of the ulnar nerve was measured at 3 points of condylar, proximal, and distal level of the cubital tunnel. RESULTS: No side effects were reported during the study period. The visual analog scale and cross-sectional area showed a significant decrease at 1st week and 4th week, as compared to baseline (p<0.05). The electrophysiological severity scale was significantly decreased at the 4th week, as compared with baseline and 1st week (p<0.05). Among the quantitative components of the scale, there were statistically significant improvements with respect to the conduction velocity and block. CONCLUSION: The new approach of US-guided injection may be a safe tool for the treatment of CuTS. Symptomatic and morphologic recoveries preceded the electrophysiological improvement.
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spelling pubmed-44149632015-04-30 Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study Choi, Chang Kweon Lee, Hyun Seok Kwon, Jae Yeoun Lee, Won-Jae Ann Rehabil Med Original Article OBJECTIVE: To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes. METHODS: A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by an electrodiagnostic study, participated in this study. US-guided injection into the cubital tunnel was performed with 40 mg triamcinolone and 2 mL of 1% lidocaine. Outcomes of the injections were evaluated at pre-injection, 1st week and 4th week after injection. Visual analog scale, self-administered questionnaire of the ulnar neuropathy at the elbow (SQUNE), and McGowan classification were used for clinical evaluation. Cross-sectional area of the ulnar nerve by US and the electrophysiological severity scale through a nerve conduction study were utilized in the evaluation of morphologic and electrophysiological changes. The cross-sectional area of the ulnar nerve was measured at 3 points of condylar, proximal, and distal level of the cubital tunnel. RESULTS: No side effects were reported during the study period. The visual analog scale and cross-sectional area showed a significant decrease at 1st week and 4th week, as compared to baseline (p<0.05). The electrophysiological severity scale was significantly decreased at the 4th week, as compared with baseline and 1st week (p<0.05). Among the quantitative components of the scale, there were statistically significant improvements with respect to the conduction velocity and block. CONCLUSION: The new approach of US-guided injection may be a safe tool for the treatment of CuTS. Symptomatic and morphologic recoveries preceded the electrophysiological improvement. Korean Academy of Rehabilitation Medicine 2015-04 2015-04-24 /pmc/articles/PMC4414963/ /pubmed/25932413 http://dx.doi.org/10.5535/arm.2015.39.2.176 Text en Copyright © 2015 by Korean Academy of Rehabilitation Medicine http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Chang Kweon
Lee, Hyun Seok
Kwon, Jae Yeoun
Lee, Won-Jae
Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title_full Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title_fullStr Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title_full_unstemmed Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title_short Clinical Implications of Real-Time Visualized Ultrasound-Guided Injection for the Treatment of Ulnar Neuropathy at the Elbow: A Pilot Study
title_sort clinical implications of real-time visualized ultrasound-guided injection for the treatment of ulnar neuropathy at the elbow: a pilot study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414963/
https://www.ncbi.nlm.nih.gov/pubmed/25932413
http://dx.doi.org/10.5535/arm.2015.39.2.176
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