Ultrasound-Guided Injection of Carpal Tunnel Syndrome Using Hyaluronic Acid vs Corticosteroid vs Glucose 5%

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder caused by compression of the median nerve at the wrist. This study is a comparative study designed to evaluate the efficacy of three ultrasound-guided injection treatments for patients with mild to moderate CTS: hyaluronic acid (HA), corticosteroid, and 5% glucose (D5W). A total of 60 adult patients with clinically and electrophysiologically confirmed mild to moderate CTS will be enrolled and divided into three groups of 20 patients each. Participants will receive a single ultrasound-guided injection using one of the three study interventions. Clinical assessment will include Phalen's test and Tinel's sign. Electrophysiological assessment will include median nerve sensory and motor nerve conduction parameters, while ultrasonographic assessment will include measurement of the median nerve cross-sectional area. Participants will be reassessed three months after the intervention using the same clinical, electrophysiological, and ultrasonographic measures. The study will compare changes in these outcomes among the three treatment groups to evaluate their relative efficacy in the management of mild to moderate CTS.

Inclusion Criteria: Adults aged 18-70 years. Clinical symptoms of carpal tunnel syndrome for ≥6 weeks. Electrophysiological confirmation of mild to moderate carpal tunnel syndrome. Ability to provide informed consent. \- Exclusion Criteria: * Prior injection into the same wrist within the previous 6 months. Previous carpal tunnel surgery. Severe carpal tunnel syndrome, defined by absent sensory potentials or electromyographic evidence of denervation. Local infection or coagulopathy.