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Comparative study on the effectiveness of a corticosteroid injection for carpal tunnel syndrome in patients with and without Raynaud’s phenomenon

Title
Comparative study on the effectiveness of a corticosteroid injection for carpal tunnel syndrome in patients with and without Raynaud’s phenomenon
Authors
Roh Y.H.Noh J.H.Gong H.S.Baek G.H.
Ewha Authors
노영학
SCOPUS Author ID
노영학scopus
Issue Date
2017
Journal Title
Bone and Joint Journal
ISSN
2049-4394JCR Link
Citation
vol. 99B, no. 12, pp. 1637 - 1642
Publisher
British Editorial Society of Bone and Joint Surgery
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Aims The aim of this study was to compare the efficacy of a corticosteroid injection for the treatment of carpal tunnel syndrome (CTS) in patients with and without Raynaud’s phenomenon. Patients and Methods In a prospective study, 139 patients with CTS were treated with a corticosteroid injection (10 mg triamcinolone acetonide); 34 had Raynaud’s phenomenon and 105 did not (control group). Grip strength, perception of touch with a Semmes-Weinstein monofilament and the Boston Carpal Tunnel Questionnaires (BCTQ) were assessed at baseline and at six, 12 and 24 weeks after the injection. The Cold Intolerance Severity Score (CISS) questionnaire was also assessed at baseline and 24 weeks after the injection. Results The two groups had similar baseline BCTQ scores, but the scores in the Raynaud’s phenomenon group were significantly higher than those in the control group at 12 and 24 weeks after the injection. Throughout the 24-week follow-up, there were no significant differences in the mean grip strength between the groups, whereas the mean Semmes-Weinstein monofilament sensory index for the control group was significantly higher than that of the Raynaud’s phenomenon group. The mean CISSs were not significantly different between the groups at baseline and at 24 weeks. After 24 weeks, 11 patients (32%) in the Raynaud’s phenomenon group and 16 (15%) in the control group required carpal tunnel decompression (p = 0.028). Multivariable analysis indicated that concurrent Raynaud’s phenomenon (odds ratio (OR) 2.6) and severe electrophysiological grade (OR 2.1) were independently associated with a failure of treatment after a corticosteroid injection. Conclusion Although considerable improvements in symptoms will probably occur in patients with Raynaud’s phenomenon who have CTS, they have higher risk of poor functional outcomes and failure of treatment than those without Raynaud’s phenomenon. © 2017 The British Editorial Society of Bone & Joint Surgery.
DOI
10.1302/0301-620X.99B12.BJJ-2017-0371.R2
Appears in Collections:
의과대학 > 의학과 > Journal papers
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