scholarly journals Combined Sensory Index Test versus Diagnostic Ultrasonography in Early Detection of Carpal Tunnel Syndrome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M M A Mustafa ◽  
N Nassar ◽  
I Amen ◽  
H Abdelmohsen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Early Detection ◽  
Carpal Tunnel ◽  
Control Group ◽  
Index Test ◽  
Control Groups ◽  
Tunnel Syndrome ◽  
Diagnostic Ultrasonography ◽  
And Control ◽  
Symptoms And Signs

Abstract Objectives to evaluate combined sensory index test (CSI) versus diagnostic ultrasonography in early detection of carpal tunnel syndrome. Patients and Methods case control cross sectional study was performed on twenty patients with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months and twenty apparently healthy volunteers included as a control group. All patients and controls were assessed and underwent ultrasound of the wrist and electrophysiological testing. Data from patients and control groups were compared to determine the diagnostic relations in patients with CTS. Results This study include 20 Patient with ages ranged from 25 to 45 with mean±SD (36.8±6.1) years with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months. The control group ages ranged from 25 to 45 with mean±SD (57.63±6.41) years. Our results revealed that CSI ranged from (0.7-1.9ms) with mean ± SD (1.36± 0.366) in CTS group and ranged from (0.2-0.8ms) with mean ±SD (0.59± 0.187) in control group (P < 0.001), cutoff point was > 0.8ms with sensitivity 85%, specificity 100% and accuracy 97.5%. Our diagnostic ultrasound results revealed that Inlet Outlet Ratio of CSA of median nerve ranged from (1-1.6) with mean ± SD (1.26 ± 0.226) in CTS group and from (0.7-1.1) with mean ± SD (0.92 ± 0.134) in control group (P < 0.001) with sensitivity was 80%, specificity 70% and accuracy 85%. By combination of both electrodiagnostic test (CSI) and diagnostic ultrasound (IOR) in early detection of CTS, our results revealed highly statistically significant difference between patient and control groups (P < 0.001) with sensitivity 100%, specificity 70%, and accuracy 85%. Conclusion Combined sensory index (CSI) is indicated in suspected cases of CTS with positive symptoms and negative signs. US is not an alternative diagnostic tool to electrodiagnostic tests but they are complementary.

scholarly journals Effectiveness of combined ultrasound and exercise therapy in the treatment of carpal tunnel syndrome - randomized, placebo-controlled investigation

2018 ◽  
Vol 146 (9-10) ◽  
pp. 561-566
Author(s):  
Milica Lazovic ◽  
Mirjana Kocic ◽  
Marija Hrkovic ◽  
Dejan Nikolic ◽  
Ivana Petronic ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Pain Intensity ◽  
Carpal Tunnel ◽  
Sensory Nerve ◽  
Ultrasound Treatment ◽  
Control Group ◽  
Short Term ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
And Control

Introduction/Objective. The aim of the paper was to evaluate the short-term effectiveness of ultrasound treatment procedure on defined clinical parameters and changes of electrodiagnostic parameters at the median nerve in carpal tunnel syndrome patients. Methods. Thirty-five patients (50 hands) were randomly divided into two groups: the experimental group (EG) (20 patients (29 hands)) and the control group (CG) (15 patients (21 hands)). Twenty sessions of ultrasound treatment were performed over a period of seven weeks and control examination was performed during the eighth week from the initial session. Clinical assessment parameters (pain intensity, superficial sensibility, and Tinel sign), and electrodiagnostic parameters (motor distal latency ? mDL), median sensory nerve conduction velocity (SNCV), and median sensory nerve action potential (SNAP) were assessed both at baseline (T1) and at control (T2). Results. There is significant improvement of pain intensity (T1 ? 10.4/58.6/31; T2 ? 65.5/27.6/6.9; p < 0.001) and superficial sensibility (T1 ? 3.4/69/27.6; T2 ? 44.8/34.5/20.7; p < 0.001) in the EG after the treatment. In the EG, there is significant reduction in frequency of positive Tinel?s sign (T1 ? 100/0; T2 ? 62.1/37.9; p < 0.001), and mDL significantly decreased after the treatment (T1 ? 4.7 ? 1.3; T2 ? 4.5 ? 1.2; p = 0.007), while SNAP (T1 ? 20.2 ? 15.4; T2 ? 24.4 ? 16.5; p < 0.001) and SNCV (T1 ? 36.5 ? 9.8; T2 ? 42.6 ? 9.7; p < 0.001) significantly increased. Conclusion. Ultrasound treatment along with exercises have positive short-term effects and benefits on improvement of clinical and electrodiagnostic findings in individuals with carpal tunnel syndrome.

scholarly journals Sensory-Motor Index is Useful Parameter in Electroneurographical Diagnosis of Carpal Tunnel Syndrome

2006 ◽  
Vol 6 (3) ◽  
pp. 23-27 ◽  
Author(s):  
Zoran Perić ◽  
Osman Sinanović
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
False Negative ◽  
Mean Value ◽  
Control Group ◽  
Normal Value ◽  
Sensory Motor ◽  
Tunnel Syndrome ◽  
And Control

It was performed electroneurographic (ENG) studies with surface electrodes and examined nervus medianus (NM) in 60 patients (38 females), average age of 50,28 years (X+/-SD=50,28+/-11), with clinical diagnosis of carpal tunnel syndrome (CTS) and at least one border or discrete abnormal value of conventional electrophysiological tests. It was also examined 57 healthy individuals (33 females) as control group, average age of 45,65 years (X+/-SD=45,65+/-9,68). The sensitivity and specificity of sensory-motor index (SMI), terminal latency index(TLI) and residual latency (RL) were calculated and compared. SMI is determinate by using following formula: distal distance (DD) (in cm)/distal motor latency (DML) (in ms) + sensory conduction velocity (SCV) (in m/s)/motor conduction velocity (MCV) (in m/s) of NM. SCV of NM was measured by antidromic technique in segment wrist-index finger and MCV of NM in forearm segment above wrist. SMI mean value of control group was 3,45 (X+/-SD=3,45+/-0,45) with lower limit of normal value 2,82 and in patients with CTS 2,13 (X+/-SD=2,13 +/-0,37). The sensitivity of SMI in patients with CTS was 98,51%. SMI is useful parameter in electroneurographical diagnosis of CTS and it's determination is easy and fast and specially important in cases with border or discrete abnormal values of other NM electrophysiological parameters, when SMI values can indicate incipient phase of CTS evolution. In rare cases (about 1%) of CTS with selective NM motor axons affection, SMI may have normal value (false negative result), but DML is always prolonged in this cases. SMI is not dependent on age and DD values in patients with CTS and control subjects.

scholarly journals Comparison between Carpal Tunnel Syndrome and Individuals with Symptoms of Obsessive- Compulsive Disorder

2020 ◽  
Author(s):  
Meliha GÜNDAĞ PAPAKER ◽  
Anas ABDALLAH ◽  
Mehmet Hakan SEYİTHANOĞLU ◽  
Engin CAN ◽  
Aygül TANTİK PAK ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Patient Group ◽  
Carpal Tunnel ◽  
Significant Relationship ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Tunnel Syndrome ◽  
Anxiety Levels ◽  
The Difference

Abstract Objective: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy and is seen in 3 % of the general population. The aim to this study was examine the relationship between the symptoms of cleaning compulsion with using Moudsley obsessive compulsive inventory ( MOCI ) and patients with CTS. Methods: Sixty patients with CTS and 60 healty controls were evaluated in Bezmialem Vakif University Faculty of Medicine Neurosurgery Clinic. Neurological examination, Electrophysiological findings, the presence of neuropathic pain evaluated by the Leeds assessment of neuropathic symptoms and signs (LANSS) , the symptoms of obsessive- compulsive disorder using with MOCI and anxiety levels assessed by the Beck Anxiety Inventory (BAI) were evaluated. Results: No statistically significant relationship was observed between anxiety levels and CTS (p › 0.005). No statistically significant relationship was found MOCI rumination, control and doubting subscale scores (p › 0.005). Patient group had higher MOCI cleaning subscale scores than the control group and the difference was statistically significant (p=0.008). Patient group had higher MOCI slowness subscale scores than the control group and the difference was statistically significant (p=0.004). Conclusion: Increased wrist movement in people that have the symptoms of compulsive cleaning is associated with the risk of CTS. Our study show that a reduction of high level of wrist flexion-extansion movements may decrease the new CTS cases.

scholarly journals The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

2015 ◽  
Vol 123 (5) ◽  
pp. 1230-1237 ◽  
Author(s):  
Daniele Vanni ◽  
Francesco Saverio Sirabella ◽  
Renato Galzio ◽  
Vincenzo Salini ◽  
Vincenzo Magliani
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Control Group ◽  
P Value ◽  
Invasive Approach ◽  
Group A ◽  
Tunnel Syndrome

OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.

Radiographic Predictors of Delayed Carpal Tunnel Syndrome After Distal Radius Fracture in the Elderly

Hand ◽  
2020 ◽  
pp. 155894472096387
Author(s):  
Kevin H. Kim ◽  
Bryan Duell ◽  
Swapna Munnangi ◽  
Mitchell Long ◽  
Elizabeth Morrison
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Carpal Tunnel Syndrome ◽  
Distal Radius Fracture ◽  
Carpal Tunnel ◽  
Nonoperative Management ◽  
Significant Risk ◽  
The Elderly ◽  
Control Group ◽  
Tunnel Syndrome

Background Delayed-onset carpal tunnel syndrome (DCTS) can develop weeks and months after distal radius fracture (DRFx). A better understanding of the risk factors of DCTS can guide surgeon’s decision making regarding the management of DRFx and also provides another discussion point to be had with elderly patients when discussing outcomes of nonoperative management. Methods We reviewed 216 nonoperatively managed DRFx between June 2015 and January 2019 at a single level 1 trauma center and senior author’s office. We identified 26 patients who developed DCTS at a minimum of 6 weeks after DRFx, which constituted our case group. The remaining 190 patients served as the control group (non–carpal tunnel syndrome [CTS]). Differences between case and control group were evaluated through univariate and multivariate analyses. Results The prevalence of DCTS among nonoperatively managed DRFx was 12%. In univariate analysis, volar tilt (VT) and teardrop angle (TDA) were significant independent predictors of development of DCTS. Multivariate logistic regression analysis determined that the odds of developing CTS increased by 12% and 24% for each degree of decrease in VT and TDA, respectively. No other significant risk factors were identified. Conclusions Decreasing VT and TDA are the most significant risk factors associated with DCTS in nonoperatively managed DRFx. These are simple and reliable radiographic measurements that provide significant prognostic value. These parameters can be used to guide surgeon decision making regarding management of DRFx in the elderly while aiding patient expectations and outcomes following nonoperative management of DRFx.

Use of Nerve Conduction Studies and the Pressure-Specified Sensory Device in the Diagnosis of Carpal Tunnel Syndrome

2009 ◽  
Vol 34 (1) ◽  
pp. 60-65 ◽  
Author(s):  
D. J. SLUTSKY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Diagnostic Yield ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Control Group ◽  
Asymptomatic Volunteers ◽  
Before And After ◽  
Tunnel Syndrome

Sixty-nine patients with signs of carpal tunnel syndrome (CTS) underwent nerve conduction studies (NCS) and testing with the Pressure-Specified Sensory Device (PSSD). A total of 102 tests were performed (28 bilateral). Twenty patients underwent a carpal tunnel release and were retested after 4 to 6 months. The Symptom Severity Score (SSS) was calculated before and after surgery. A control group of 20 hands in 10 asymptomatic volunteers underwent identical testing. The NCS sensitivity was 87% with a specificity of 90% whereas the PSSD sensitivity was 81% with a specificity of 65%. The combined sensitivity of the two tests was 93%. In the operative group the SSS improved from a mean of 3.34 pre-operatively to 1.95 postoperatively. The NCS improved in 19/21 hands whereas the PSSD improved in 16/19 hands. The non-invasive SSS and PSSD can increase the diagnostic yield in CTS, especially when the NCS are normal.

Correspondence between clinical presentation and electrophysiological testing for potential carpal tunnel syndrome

2012 ◽  
Vol 38 (5) ◽  
pp. 489-495 ◽  
Author(s):  
H. S. Makanji ◽  
M. Zhao ◽  
C. S. Mudgal ◽  
J. B. Jupiter ◽  
D. Ring
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Pain Catastrophizing ◽  
Future Studies ◽  
Secondary Purpose ◽  
Electrophysiological Testing ◽  
Tunnel Syndrome ◽  
Nerve Dysfunction ◽  
Symptoms And Signs

The diagnosis of carpal tunnel syndrome (CTS) is often applied in the absence of objectively verifiable pathophysiology (i.e. electrophysiologically normal carpal tunnel syndrome). The primary purpose of this study was to determine whether depressive symptoms, heightened illness concern, and pain catastrophizing are associated with an absence of electrophysiological abnormalities. The secondary purpose was to examine the correspondence between the Levine scale, the CTS-6, and electrophysiological abnormalities. Ninety-eight participants completed validated questionnaires assessing psychosocial factors at the initial visit, and surgeons recorded clinical data and their confidence that the diagnosis was carpal tunnel syndrome. Symptoms and signs that are characteristic of carpal tunnel syndrome (e.g. the CTS-6 and Levine scale) significantly, but incompletely coincided with electrophysiological testing. Psychological factors did not help distinguish patients with normal and abnormal objective testing and it remains unclear if symptoms that do not coincide with abnormal tests represent very mild, immeasurable median nerve dysfunction or a different illness altogether. Future studies should address whether outcomes are superior and resource utilization is optimized when surgery is offered based on symptoms and signs (e.g. the CTS-6) or when surgery is offered on the basis of measurable pathophysiology.

ELECTRODIAGNOSTIC CRITERIA FOR DIAGNOSING CARPAL TUNNEL SYNDROME NEED TO BE REVISED IN HYPOTHYROID PATIENTS

2017 ◽  
Vol 20 (03) ◽  
pp. 1750014
Author(s):  
Mahdieh Asadi ◽  
Sharareh Roshanzamir
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Control Group ◽  
Tunnel Syndrome ◽  
Clinical Signs And Symptoms ◽  
Relationship Of ◽  
Hypothyroid Patients

Background: Previous studies do not agree with each other on the association between electrodiagnostic findings and clinical symptoms of Carpal tunnel syndrome (CTS). In most of these studies, many variables such as age, sex, obesity and hypothyroidism have not been taken into account. Material & methods: About 62 patients with hypothyroidism and 62 patients without hypothyroidism with sign and symptoms of CTS were included in this study. Electrodiagnostic tests were done for all patients. And relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters was examined statistically in each group. Results: This study showed that distal motor latency in control group (without hypothyroidism) is significantly more prolonged than hypothyroid patients. Also there was significant correlation between clinical symptoms and electrodiagnostic findings in control group, but there was not such correlation in hypothyroid patients. In 62% of hypothyroid patients with clinical signs and symptoms of CTS, electrodiagnostic findings were normal and only in 38% of cases, electrodiagnostic findings were suggestive of CTS. Conclusion: Relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters is very weak in hypothyroid patients. Many hypothyroid patients with clinical signs and symptoms of CTS have normal electrodiagnostic findings; so we need more studies for revising the para-clinic criteria of labeling patients having CTS in hypothyroid patients.

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