# Treatment Monitoring of Carpal Tunnel Syndrome Using Shear Wave Elastography: A Pilot In Vivo Study

## TL;DR

This study explores whether a non-invasive imaging technique called shear wave elastography can track improvements in carpal tunnel syndrome after corticosteroid injections.

## Contribution

The study is among the first to use shear wave elastography to monitor treatment outcomes in carpal tunnel syndrome patients.

## Key findings

- Corticosteroid injections improved symptom scores and changed median nerve stiffness measurements.
- Shear wave elastography showed significant changes in pressure and velocity after treatment.
- Questionnaires were more reliable than elastography for predicting the need for surgery.

## Abstract

Purpose: Shear wave elastography (SWE) is a non-invasive technique for assessing median nerve (MN) stiffness in carpal tunnel syndrome (CTS). This study evaluated whether SWE measurements of the MN improve after corticosteroid injection (CSI) and correlate with symptom improvement in CTS.

Methods: Ten patients (18 wrists) with CTS underwent SWE, grip strength testing, and completed questionnaires before and six weeks after ultrasound-guided CSI. SWE measurements included pressure and velocity in longitudinal/transverse planes at two locations: proximal to and at the carpal tunnel. Progression to carpal tunnel release (CTR) was recorded. Multivariate analyses assessed associations between SWE and symptom scores, controlling for confounders.

Results: Functional Status Scale (FSS) and Symptom Severity Scale (SSS) scores improved post-injection (p=0.007 and p<0.001, respectively). Significant changes occurred in SWE carpal tunnel pressure and velocity (p<0.05). No significant association between SWE and CTR progression. Post-injection proximal MN pressure (p=0.005) and velocity (p=0.006) measured longitudinally were associated with FSS scores.

Conclusion: SWE measurements change with CSI but do not consistently predict symptom relief or surgery need. Questionnaires on daily function and symptoms may be more reliable for outcome tracking.