scholarly journals Ultrasonic Assessment of Females with Carpal Tunnel Syndrome Proved by Nerve Conduction Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ihsan M. Ajeena ◽  
Raed H. Al-Saad ◽  
Ahmed Al-Mudhafar ◽  
Najah R. Hadi ◽  
Sawsan H. Al-Aridhy
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Cross Section Area ◽  
Significant Difference ◽  
Tunnel Syndrome

Introduction. Carpal tunnel syndrome (CTS) is the most commonly diagnosed entrapment neuropathy of the upper extremity. The objective of this study was to diagnose CTS and to assess its severity using high resolution ultrasound (HRUS) depending on the results of nerve conduction study (NCS).Methods. A prospective cross-sectional study, in which HRUS was performed at 63 wrists of 35 female patients with different severity of CTS (as proved by NCS). Furthermore, 40 healthy volunteers (80 wrists) underwent the same tests as the patients and have been chosen to match the patients in gender, age, and body mass index (BMI). The cross section area (CSA) of the median nerve (MN) was obtained using HRUS at the carpal tunnel inlet by direct tracing method.Results.There was a significant difference in the CSA of the MN at the tunnel inlet in CTS patients when compared with the control group. In fact, the CSA of the control group showed a significant difference from each of patients subgroups. Furthermore, a significant difference in the CSA was seen in between these subgroups. In conclusion, the US examination of the MN seems to be a promising method in diagnosing and grading of carpal tunnel syndrome.

scholarly journals High prevalence of carpal tunnel syndrome in individuals with rare nerve growth factor-beta mutation

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Mikael Ridderström ◽  
Mats Svantesson ◽  
Oumie Thorell ◽  
Theofilos Magounakis ◽  
Jan Minde ◽  
...  
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Cross Sectional ◽  
Nerve Growth ◽  
Tunnel Syndrome ◽  
Growth Factor Beta

Abstract In Sweden, a large family with a point mutation in the nerve growth factor-beta gene has previously been identified. The carriers of this mutation have reduced small-fibre density and selective deficits in deep pain and temperature modalities. The clinical findings in this population are described as hereditary sensory and autonomic neuropathy type V. The purpose of the current study was to investigate the prevalence of carpal tunnel syndrome in hereditary sensory and autonomic neuropathy type V based on clinical examinations and electrophysiological measurements. Furthermore, the cross-sectional area of the median nerve at the carpal tunnel inlet was measured with ultrasonography. Out of 52 known individuals heterozygous for the nerve growth factor-beta mutation in Sweden, 23 participated in the current study (12 males, 11 females; mean age 55 years; range 25–86 years). All participants answered a health questionnaire and underwent clinical examination followed by median nerve conduction study in a case–control design, and measurement of the nerve cross-sectional area with ultrasonography. The diagnosis of carpal tunnel syndrome was made based on consensus criteria using patient history and nerve conduction study. The prevalence of carpal tunnel syndrome in the hereditary sensory and autonomic neuropathy group was 35% or 52% depending on whether those individuals who had classic symptoms of carpal tunnel syndrome but negative nerve conduction studies were included or not. Those who had a high likelihood of carpal tunnel syndrome based on classic/probable patient history with positive nerve conduction study had a significantly larger median nerve cross-sectional area than those who had an unlikely patient history with negative nerve conduction study. The prevalence of carpal tunnel syndrome was 10–25 times higher in individuals heterozygous for the nerve growth factor-beta mutation than the general Swedish population. Further studies are needed to better understand the underlying pathophysiological mechanisms.

Correlation of clinical grading, physical tests and nerve conduction study in carpal tunnel syndrome

2018 ◽  
Vol 18 (3) ◽  
pp. 345-350 ◽  
Author(s):  
Sadegh Izadi ◽  
Bahareh Kardeh ◽  
Seied Saeed Hosini Hooshiar ◽  
Mojtaba Neydavoodi ◽  
Afshin Borhani-Haghighi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Rating Scale ◽  
Screening Method ◽  
Cross Sectional ◽  
Physical Tests ◽  
Tunnel Syndrome ◽  
Clinical Grading

AbstractBackground and aimsCarpal tunnel syndrome (CTS) is a common debilitating condition. As the reliability of CTS-specific physical tests and its clinical grading remain a matter of debate, we determined the correlations between these assessments with nerve conduction study (NCS).MethodsIn this cross-sectional study, patients with uni or bilateral CTS, which was confirmed in electrodiagnosis, were enrolled. Clinical grading was based on the modified criteria of the Italian CTS Study Group. Numeric Pain Rating Scale (NPRS) and Boston Questionnaire (BQ) were used. Physical tests [Phalen’s, reverse Phalen’s, Tinel’s and manual carpal compression test (mCCT)] were performed by a single blinded neurologist. Ap-value<0.05 was considered statistically significant.ResultsA total of 100 patients (age=47.48±11.44 years; 85% female) with 181 involved hands were studied. The majority of hands (59.7%) were classified as grade 2 of clinical grading. On NCS, hands with mild (64%), moderate (27%) and severe (9%) CTS were identified. Sensory (velocity, latency and amplitude) and motor parameters (latency and amplitude) were significantly correlated with clinical grades (p-value<0.001). The correlation of NPRS (p-value=0.009) and BQ (p-value<0.001) scores with NCS was significant. None of the physical tests were significantly correlated with NCS in terms of result or duration (p-value>0.05).ConclusionsWe found that physical tests are not a reliable screening method for evaluation of CTS severity. However, the BQ and clinical grading can be more valuable due to their significant correlation with NCS.ImplicationsPhysicians might benefit from employing clinical grading and BQ in practice for better assessment of CTS severity.

scholarly journals The value of sonographic quantitative parameters in the diagnosis of carpal tunnel syndrome in the Vietnamese population

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110644
Author(s):  
Nhu Quynh Vo ◽  
Thi Hieu Dung Nguyen ◽  
Duy Duan Nguyen ◽  
Trong Binh Le ◽  
Nghi Thanh Nhan Le ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Sensitivity And Specificity ◽  
Carpal Tunnel ◽  
Area Under The Curve ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Vietnamese Population ◽  
Tunnel Syndrome

Objective To examine the value of ultrasound (US) in the diagnosis of carpal tunnel syndrome (CTS) in the Vietnamese population. Methods This prospective cross-sectional study involved 42 wrists of 25 patients with idiopathic CTS evaluated by US. In addition, 38 wrists of 22 healthy volunteers were included as the control group. Results Significant differences in the median nerve cross-sectional area (CSA) at different levels were found between patients with CTS and controls. Using a cut-off value of 9.5 mm2 for the median nerve CSA at the pisiform (p-CSA), US had a sensitivity and specificity of 95.2% and 97.4%, respectively, for the diagnosis of CTS. Area under the curve analysis revealed a sensitivity and specificity of 100% and 95.4%, respectively, for the prediction of severe CTS using a p-CSA of >15.5 mm2. Conclusions The median nerve CSA is a highly accurate parameter in the diagnosis of CTS. We recommend using a p-CSA of >9.5 mm2 as a diagnostic criterion for CTS and a p-CSA of >15.5 mm2 as a marker for severe CTS in the Vietnamese population. Research Registry number: 7261

Carpal tunnel decompression in patients with normal nerve conduction studies

2019 ◽  
Vol 45 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Samuel P. Mackenzie ◽  
Oliver D. Stone ◽  
Paul J. Jenkins ◽  
Nicholas D. Clement ◽  
Iain R. Murray ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Clinical Features ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Study Groups ◽  
Nerve Conduction Studies ◽  
Level Of Evidence ◽  
Tunnel Syndrome ◽  
Normal Nerve Conduction

Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III

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.

Sign in / Sign up

Export Citation Format

Share Document