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Related Experiment Video

Updated: Aug 5, 2025

Metacarpal Small Incision for Carpal Tunnel Syndrome
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Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses.

King Hei Stanley Lam1,2,3,4,5, Yung-Tsan Wu6,7,8, Kenneth Dean Reeves9

  • 1The Department of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Hong Kong.

Diagnostics (Basel, Switzerland)
|March 29, 2023
PubMed
Summary

Ultrasound-guided interventions for carpal tunnel syndrome (CTS), including injections (UPIT) and release (UPCTR), show promising benefits and safety. Further studies are needed to compare their therapeutic effectiveness directly.

Keywords:
carpal tunnel syndromeinjectioninterventionreleaseultrasound-guided

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Area of Science:

  • Orthopedics
  • Neurology
  • Medical Imaging

Background:

  • Carpal tunnel syndrome (CTS) is the most prevalent peripheral nerve entrapment disorder.
  • Ultrasound-guided perineural injection (UPIT) and percutaneous flexor retinaculum release (UPCTR) are emerging treatments for CTS.
  • A comprehensive review encompassing both UPIT and UPCTR for CTS is currently lacking.

Purpose of the Study:

  • To systematically review and meta-analyze the evidence on ultrasound-guided interventions for carpal tunnel syndrome.
  • To evaluate the effectiveness and safety of UPIT and UPCTR in managing CTS.
  • To assess the quality of evidence for these novel treatment modalities.

Main Methods:

  • A systematic review was conducted using four major databases: PubMed, EMBASE, Scopus, and Cochrane Library.
  • Sixty studies were selected for the systematic review.
  • Twenty randomized controlled trials were included in six separate meta-analyses.

Main Results:

  • Ultrasound-guided steroid injections demonstrated superior outcomes compared to landmark-guided injections and lower-dose steroids.
  • 5% dextrose in water (D5W) injections, particularly high-volume hydrodissection, showed better results than control injections.
  • Platelet-rich plasma injections and UPCTR also indicated positive outcomes, with UPCTR showing symptom improvement over open surgery.

Conclusions:

  • Both ultrasound-guided perineural injection (UPIT) and percutaneous flexor retinaculum release (UPCTR) appear to offer significant clinical benefits for carpal tunnel syndrome.
  • These ultrasound-guided procedures demonstrated a favorable safety profile with no serious adverse events reported.
  • Further comparative studies are essential to establish the relative therapeutic efficacy between different ultrasound-guided interventions for CTS.