How is a carpal tunnel steroid injection administered using an in-plane ultrasound-guided approach?

Updated: May 31, 2018
  • Author: Samir Shah, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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By using a high frequency ultrasound probe the wrist is imaged by placing the probe transverse across dorsiflexed wrist. The median nerve and ulnar artery is identified. At the level of the distal wrist crease, the needle is passed into the skin superficial to the ulnar artery, penetrating the flexor retinaculum. The needle is advanced toward the median nerve. The steroid solution is injected just under the flexor retinaculum then retracted and redirected deeper to the ulnar side of the median nerve. This allows the median nerve to be completely surrounded with the steroid solution. [3]

Short-Axis View Ultrasound Probe Placement Short-Axis View Ultrasound Probe Placement
In-Plane Approach with block needle In-Plane Approach with block needle
Short-Axis View Short-Axis View
Short-Axis View with Dopplar Short-Axis View with Dopplar

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