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.

scholarly journals Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist?

2021 ◽  
Vol 10 (18) ◽  
pp. 4208
Author(s):  
Fatma Kilinc ◽  
Bedjan Behmanesh ◽  
Volker Seifert ◽  
Gerhard Marquardt
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Long Term Results ◽  
Transverse Ligament ◽  
Tunnel Syndrome ◽  
Clinical Signs And Symptoms

The aim of this study was to evaluate whether recurrent carpal tunnel syndrome (CTS) after complete and sufficient division of the transverse ligament really exists. Another goal was to analyze the underlying reasons for recurrent CTS operated on in our department. Over an observation period of eleven years, 156 patients underwent surgical intervention due to CTS. The records of each patient were analyzed with respect to baseline data (age, gender, affected hand), as were clinical signs and symptoms pre- and postoperatively. To assess long-term results, standardized telephone interviews were performed using a structured questionnaire in which the patients were questioned about persisting symptoms, if any. Of the 156 patients, 128 underwent first surgical intervention due to CTS in our department. In long-term follow-up, two-thirds of these patients had no symptoms at all; one-third of the patients described mild persisting numbness. None of the patients experienced a recurrence of CTS. The 28 patients who received their first operation outside of our department were operated on for recurrent CTS. The cause of recurrence was incomplete division of the distal part of the transverse carpal ligament in all cases. The results suggest that recurrent CTS after complete and sufficient division of the transverse ligament is very unlikely.

RATIONAL FOR HYPOTHYROIDISM SCREENING IN CARPAL TUNNEL SYNDROME PATIENTS WITHOUT DEFINITE PREDISPOSING FACTOR

2016 ◽  
Vol 19 (04) ◽  
pp. 1650020 ◽  
Author(s):  
Sharareh Roshanzamir ◽  
Amid Azarang ◽  
Alireza Dabbaghmanesh
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Normal Female ◽  
Predisposing Factor ◽  
Study Materials ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire ◽  
Hypothyroid Patients

Background: Screening for hypothyroidism in carpal tunnel syndrome (CTS) patients is of controversy. To determine the value of hypothyroidism screening in CTS patients without definite predisposing factor we designed this study. Materials and Methods: 220 normal female and 220 female with CTS were included. We excluded any patient with a definite predisposing factor for CTS such as trauma, being manual laborer, etc. Boston carpal tunnel questionnaire was filled for each CTS patient and all the patients went under electrodiagnostic study; and a blood sample was taken to measure TSH and T4 level. Results: The prevalence of subclinical hypothyroidism was 38.2% among the CTS group, and 11.8% in control group. The level of TSH was above 10[Formula: see text]mU/L (cut off level for treatment) in 45.2% of subclinical hypothyroid patients with CTS and 11.5% of subclinical hypothyroid patients without CTS. In the subclinical hypothyroid patients with CTS there was a significant direct correlation between TSH values and the Boston questionnaire scoring (correlation coefficient with function score: 0.93 and with symptom score: 0.96) ([Formula: see text]). Conclusion: Regarding high prevalence of subclinical hypothyroidism in CTS patients without definite predisposing factor and direct association of TSH level with symptom severity we recommend screening for hypothyroidism in these patients.

Relationship of Carpal Canal Contents Volume to Carpal Canal Pressure in Carpal Tunnel Syndrome Patients

2004 ◽  
Vol 29 (3) ◽  
pp. 275-278 ◽  
Author(s):  
A. YOSHIDA ◽  
I. OKUTSU
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Flexor Digitorum Superficialis ◽  
Tunnel Syndrome ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Relationship Of ◽  
Infusion Technique

Forty patients long-term haemodialysis with a second recurrence of carpal tunnel syndrome and concomitant loss of flexor tendon function due to flexor adhesions were treated by excision of the flexor digitorum superficialis tendons. During the procedure the carpal canal pressure was measured using a continuous infusion technique. The preoperative mean carpal canal pressure was 81 (SD, 53) mmHg. After removal of all the flexor digitorum superficialis tendons, the carpal canal pressure decreased to 10 (SD, 8) mmHg. The clinical symptoms of carpal tunnel syndrome were relieved and hand strength and finger motion were improved in all patients.

scholarly journals Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods

2021 ◽  
Vol 18 (4) ◽  
pp. 1995
Author(s):  
Valentina Scalise ◽  
Fabrizio Brindisino ◽  
Leonardo Pellicciari ◽  
Silvia Minnucci ◽  
Francesca Bonetti
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Manual Therapy ◽  
Carpal Tunnel ◽  
Signs And Symptoms ◽  
Current Evidence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Therapeutic Exercises ◽  
Chi Squared ◽  
Tunnel Syndrome

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

The Most Important Risk Factors for Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Ali Asghar Sharifi
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Normal Subjects ◽  
Shape Index ◽  
Mean Values ◽  
Tunnel Syndrome ◽  
Independent Risk Factors ◽  
Hand Length

Background: The aim of this study was to determine the risk factors for carpal tunnel syndrome and its relationship with the severity of the disease. Methods: A total of 131 patients with clinical symptoms of CTS and 131 normal subjects were enrolled, of whom 121 were female both in the CTS cases and the controls. All cases were electro diagnostically confirmed and assigned to three severity groups. BMI, wrist ratio, shape index, digit index and hand length/height ratio were measured in all participants. Mean values for each item were compared between cases and controls and severity subgroups. A logistic regression analysis was performed to determine independent CTS risk factors. Results: The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Conclusion: Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are important anatomically and clinically and these are the risk factors of anatomical malfunction of the wrist in CTS.

The Relationship of the Double Crush to Carpal Tunnel Syndrome (An Analysis of 1,000 Cases of Carpal Tunnel Syndrome)

1985 ◽  
Vol 10 (2) ◽  
pp. 202-204
Author(s):  
LAWRENCE C. HURST ◽  
DAVID WEISSBERG ◽  
ROBERT E. CARROLL
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Surgery ◽  
Significant Incidence ◽  
Tunnel Syndrome ◽  
Relationship Of ◽  
The Relationship ◽  
Double Crush ◽  
Double Crush Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton’s Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.

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.

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