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Updated: Jun 30, 2026

Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Sonographically guided carpal tunnel injections: the ulnar approach
Jay Smith1, Steve J Wisniewski, Jonathan T Finnoff
1Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Mayo Clinic Sports Medicine Center, Rochester, MN 55905 USA. smith.jay@mayo.edu
Objective:
The purpose of this report is to describe a new sonographically guided technique for carpal tunnel injections using an ulnar approach.
Methods:
Previously published sonographically guided techniques for carpal tunnel injections were reviewed. Described approaches were noted to be technically challenging because of the need to perform long-axis imaging of the carpal tunnel, short-axis (out-of-plane) imaging of the needle, or both.
Results:
We developed and herein describe the ulnar approach for sonographically guided carpal tunnel injections. Advantages of this approach include transverse imaging of the carpal tunnel, long-axis (in-plane) imaging of the needle, and versatility in targeting structures within the carpal tunnel.
Conclusions:
Clinicians should consider the ulnar-sided approach when performing sonographically guided carpal tunnel injections.
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