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Arash Babaei-Ghazani,1 Bijan Forogh,1 Gholam Reza Raissi,1 Tannaz Ahadi,1 Bina Eftekharsadat,2 Naseh Yousefi,1 Shahram Rahimi-Dehgolan,3 Katayoun Moradi1 1Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran; 2Physical Medicine and Rehabilitation Research Center, Department of Physical Medicine and Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran; 3Physical Medicine and Rehabilitation Department, IKHC Center, Tehran University of Medical Sciences (TUMS), Tehran, IranCorrespondence: Shahram Rahimi-DehgolanPhysical Medicine and Rehabilitation Department, IKHC Center, Tehran University of Medical Sciences (TUMS), Tehran, IranEmail shahram.rahimi.dehgolan@gmail.comKatayoun MoradiNeuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, IranEmail katayoun-moradi69@gmail.comPurpose: To compare two common approaches for ultrasonography (US)-guided injection.Patients and Methods: Sixty patients with mild-to-moderate CTS were included in this double-blind randomized controlled trial (RCT). They received a single shot of corticosteroid injection through either the US-guided in-plane approach: radial or ulnar side. Participants were evaluated using Boston Carpal Tunnel Questionnaire (BCTQ) and visual analogue scale (VAS) for pain, as well as electrodiagnosis (EDX) and US parameters before the intervention, and within 12 weeks of follow-up.Results: In both groups, all outcomes, except for the electrodiagnostic measures, significantly improved within the follow-up. Pain-VAS and both subscales of BCTQ questionnaire, as our main subjective outcomes, revealed dramatic improvement, with the largest amount of changes in VAS (70%; comparing to baseline value), and about 37% for both of BQSS and BQFS scales, all indicating superiority of radial to ulnar in-plane approach. During the first follow-up, we did not detect any remarkable preference between the groups in either subjective or electrodiagnostic variables. However, there was a significant difference at next follow-up time-points in terms of VAS for pain and BQFS favoring radial approach (Table 3). Furthermore, US-measured parameters including nerve-circumference and CSA improved only in the radial in-plane group.Conclusion: The current data proved that radial in-plane approach for CTS injection could be at least as effective as the more common ulnar in-plane method. Even the pain-relief effect was longer for the radial in-plane approach. Also, patients’ functional status and objective variables all revealed better outcomes via the new approach.Keywords: electromyography, corticosteroid injection, Boston Carpal Tunnel Questionnaire, BCTQ, carpal tunnel syndrome, CTS

Seyed Ahmad Raeissadat,1,2 Seyed Mansoor Rayegani,2 Bijan Forogh,3 Porya Hassan Abadi,4 Mahsa Moridnia,5 Shahram Rahimi Dehgolan6 1Clinical Development Research Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences,Tehran, Iran 2Shohada-e-Tajrish Hospital, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3College of Medical and Dental Sciences, Birmingham Medical School, Birmingham, UK; 4Physical Medicine and Rehabilitation Department, Iran University of Medical Sciences, 5Shahid Beheshti University of Medical Sciences, Deputy of Education, 6Physical Medicine and Rehabilitation Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Purpose: Knee osteoarthritis (OA) is a common disease, imposing a great burden through pain and decreased function. There are many therapeutic modalities including non-pharmacologic choices and oral, topical, and intra-articular medications. New studies have shown promising results for ozone application in knee OA. Our aim was to compare the effects of ozone therapy versus hyaluronic acid (HA) intra-articular injection in knee OA patients.Methods: In this randomized clinical trial, a total of 174 patients with more than 3 months of chronic pain or swelling in the knee joints along with consistent imaging findings were enrolled and randomly allocated into two groups of HA and ozone, which were planned to undergo 3 weekly injections of HA (Hyalgan®) and 10 mL of a 30 µg/mL ozone solution, respectively. Patients were evaluated at baseline and 6 months after the last injection for pain, stiffness, and function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Results: No major adverse events were detected in this study. Total WOMAC score decreased from 40.8±9.8 to 20.4±4.9 (p