88 patients were randomized in this study which compared the efficacy and safety of ultrasound-guided hyaluronic acid and betamethasone (corticosteroid) injections for reduction of thumb osteoarthritis symptom severity. The algofunctional index for hand osteoarthritis (FIHOA), Visual Analogue Scale (VAS), physical and mental component of the Short Form (SF-36) questionnaire were among the outcomes assessed at 7, 14, 30, 90, and 180 days. The results indicated that no significant difference in any outcome measures between groups in the total sample. However, subgroup analysis revealed that patients with more severe cases of functional disability and pain experienced significantly greater improvements after receiving hyaluronic acid injections compared to corticosteroid injections.