Please select the eligibility criteria that correspond to the clinical trial below.
Title: Local Steroid Injection in the Treatment of Idiopathic Carpal Tunnel Syndrome: A Randomized Double-blind Placebo-controlled Trial Among Patients Planned for Surgical Treatment
Brief Summary: The aim of this study is to assess the efficacy of injecting steroid into the carpal tunnel in relieving symptoms of carpal tunnel syndrome for at least 1 year with outcomes measured with patient evaluated symptoms score.Out of the patients referred by primary care, those with a clinical diagnosis of CTS who have tried wrist splint and whose symptom severity is judged by the examining surgeon to warrant surgery are offered to be put on the waiting list for carpal tunnel release. This means a waiting time of approximately 3 months. Patients who give informed consent will be asked to attend the outpatient clinic for a physical examination followed by allocation to one of the three trial groups. Immediately following the allocation the patients will receive the assigned treatment.


Options:
A: Inclusion Criteria:

* adult patients, \>/=18 years of age
* early rheumatoid arthritis (disease symptoms \<1 year) according to ACR criteria
* disease activity DAS28 \>2.6
* body weight \</=110kg, BMI \</=36

Exclusion Criteria:

* rheumatic autoimmune disease other than RA
* current inflammatory joint disease other than RA
* previous treatment with any DMARD or biologic drug used in the treatment of RA
* intra-articular, parenteral or oral glucocorticoids used for the arthritis
B: Inclusion Criteria:

* Primary idiopathic CTS
* Symptoms of classic or probable CTS according to the Katz diagnostic criteria (numbness and/or tingling in at least 2 of the 4 median nerve innervated fingers)
* Failed treatment with wrist splinting (2 months)
* Nerve conduction tests showing median neuropathy at the wrist or, if normal, two orthopedic surgeons independently make CTS diagnosis
* Symptom severity that warranted referral for consideration for surgery

Exclusion Criteria:

* Previous steroid injection for CTS
* Thenar muscle atrophy
* Sensory deficit (two-point discrimination \>8 mm)
* Diabetes, thyroid disorder, or inflammatory disease
* Polyneuropathy or vibration-induced neuropathy
* Current pregnancy
* Previous carpal tunnel surgery on the study hand
* Surgery on the contralateral hand in the past 2 months
* Inability to respond to questionnaires
* Severe medical illness
* Known drug/alcohol abuse
C: Inclusion Criteria:

* Primary, idiopathic CTS
* Age 18-70 years, either gender
* Symptom duration of at least 3 months and inadequate response to wrist splint
* Symptoms of classic or probable CTS according to the diagnostic criteria in Katz hand diagram
* Nerve conduction studies showing median neuropathy at the wrist and no other abnormalities or, in the absence of abnormal nerve conduction study results, 2 surgeons should independently diagnose the patient with CTS.
* Scheduled for carpal tunnel release (ie, symptom severity indicating need for surgery)exclusion criteria

Exclusion Criteria:

* Previous steroid injection for CTS in the same wrist
* Inflammatory joint disease, diabetes mellitus· Vibration-induced neuropathy, polyneuropathy
* Pregnancy
* Trauma to the affected hand in the previous year
* Previous CTS surgery in the affected hand
* Inability to complete questionnaires due to language problem or cognitive disorder
* Severe medical illness
* Known abuse of drugs and/or alcohol
D: Inclusion Criteria:

* pain and paresthesia in the median nerve distribution without extra-median nerve territory symptoms;
* increasing symptoms during night;
* Tinel sign;
* Phalen sign;
* self-reported hand strength deficits.
* Deficits of sensory and motor nerve conduction of the median nerve according to standardized guidelines of the American Association of Electrodiagnosis, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation

Exclusion Criteria:

* if any sensory/motor deficit in ulnar or radial nerve was present;
* previous interventions with surgery or steroid injections;
* multiple diagnoses of the upper extremity (i.e., cervical radiculopathy, lateral epicondylalgia);
* history of neck, shoulder or arm trauma;
* history of a systemic disease causing CTS (e.g. diabetes mellitus, or thyroid disease);
* history of systemic musculoskeletal conditions (e.g. rheumatoid arthritis, fibromyalgia);
* if the patient was actively involved with or seeking litigation at the time of the study;
* pregnancy.

Answer: C