scholarly journals Analysis of Sonographic Measurement by Anatomical Area in Carpal Tunnel Syndrome and Correlation the Measurement with Electrodiagnostic Study

2020 ◽  
Vol 25 (1) ◽  
pp. 8-16
Author(s):  
JungWoo Park
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Pearson Correlation ◽  
Control Group ◽  
Cross Sectional ◽  
Pearson Correlation Test ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Electrodiagnostic Study ◽  
Anatomical Area

Purpose: To evaluate effectiveness of ultrasonographic measurement of carpal tunnel by anatomical area and correlation with electrodiagnostic study in diagnosis of carpal tunnel syndrome.Methods: From September 2018 to March 2019, we performed the ultrasonography for 30 cases with carpal tunnel syndrome diagnosed with electrodiagnosis and 30 cases as control group. We measured median nerve diameter, cross-sectional area (CSA), and flattening ratio (FR) by area of carpal tunnel. We analyzed the difference of measurement between two groups and correlate the measurement with electrodiagnosis findings.Results: There was significant statistically differences in sonographic measurement between two groups by independent t-test (CSA zone 1, p=0.01; FR zone 2, p=0.000; FR zone 3; p=0.001). With Pearson correlation test, there was correlation between sonographic measurement and electrodiagnostic findings (terminal latency and nerve conduction velocity) statistically, but the Pearson coefficient was low (r<0.4). Conclusion: By anatomical area, the available value of sonographic measurement was different. But, as the values were has low power to diagnose the carpal tunnel syndrome, ultrasonography is proper to use as a complementary tool in diagnosis of carpal tunnel syndrome.

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.

Forensic Implications of Carpal Tunnel Syndrome in Relation to Neurological, Radiological and Orthopedic Assessments

2021 ◽  
Vol 15 (8) ◽  
pp. 2169-2171
Author(s):  
Muhammad Faheem Ashraf ◽  
Tanveer Haider ◽  
Shams Munir ◽  
Muhammad Imran Khan ◽  
Uzma Zaheen ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Tunnel Syndrome ◽  
Forensic Implications ◽  
Group Ii

Objective: To determine forensic implications of carpel tunnel syndrome in relation to neurological, radiological and orthopedic assessments. Study Design: Prospective Place and Duration of Study: Department of Forensic Medicine in collaboration with Radiology and Orthopaedic Departments, Govt. Khawaja Muhamamd Safdar Medical College Sialkot from 1st March 2020 to 28th February 2021. Methodology: One hundred and fifty patients of both genders were enrolled and age between 15-70 years. Details demographics age, sex and body mass index of all patients were recorded after taking written consent. Patients were divided into 2 groups. Group I had 75 patients with carpal tunnel syndrome and group II had 75 patients without carpal tunnel syndrome. Patients were undergone for ultrasonography and ultradiagnostic test used to diagnose the carpal tunnel syndrome. The carpal tunnel and proximal levels of the median nerve's CSA were measured, delta cross-sectional area (CSA) was determined for each wrist based on the differences between CSAc and CSAp. Sensitivity and specificity in wrists among both groups were identified. Results: There were 15 (20%) males and 60 (80%) females in group I with 90 wrists while in group II 17 (22.7%) males and 58 (77.3%) females in group II with 100 wrists. Mean age in group I was 49.68±9.66 years with mean BMI 26.47±9.54 kg/m2 and in group II mean age was 51.68±9.66 years with mean BMI 25.47±9.54 kg/m2. Mean CSAc in affected wrists group I was 17.11±6.44 greater than group II 08.17±6.58 mm2. Mean delta CSA in healthier wrists was lower 1.01±2.11 than group I 8.44±9.55 mm2. It was shown that the delta-CSA threshold of 2 mm2 had the maximum sensitivity (98.7%) and specificity (100%) in group I than control group. Conclusion: As compared to CSAc, the CSA is more accurate in diagnosing carpal tunnel syndrome. Keywords: Carpel tunnel syndrome (CTS), CSA, Wrists, Specificity, Sensitivity, Ultrasonography

Usefulness of ultrasound assessment of median nerve mobility in carpal tunnel syndrome

2018 ◽  
Vol 59 (12) ◽  
pp. 1494-1499 ◽  
Author(s):  
Gi-young Park ◽  
Dong Rak Kwon ◽  
Jung Im Seok ◽  
Dong-Soon Park ◽  
Hee Kyung Cho
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Dynamic Ultrasound ◽  
Peripheral Compression ◽  
Ultrasound Assessment ◽  
Tunnel Syndrome

Background Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy of the upper extremity. Recently, dynamic ultrasound (US) imaging has shown differences in median nerve mobility between the affected and unaffected sides in CTS. Purpose The present study was performed to compare the median nerve mobility between patients with CTS and healthy individuals, and to correlate median nerve mobility with the severity of CTS. Material and Methods A total of 101 patients (128 wrists) with CTS and 43 healthy individuals (70 wrists) were evaluated. Electrodiagnostic studies were initially conducted to determine the neurophysiological grading scale (NGS). The cross-sectional area (CSA) of the median nerve and the grade of median nerve mobility were measured using US. Results The mean grade of median nerve mobility in the CTS group (1.9) was significantly lower than that in the control group (2.6; P < 0.001). There were significant negative correlations between the grade of median nerve mobility and distal motor latency of the median nerve (r = –0.218, P = 0.015), NGS (r = –0.207, P = 0.020) and CSA of the median nerve (r = –0.196, P = 0.028). Conclusion The grade of median nerve mobility was negatively correlated with the severity of CTS. US assessment of median nerve mobility may be useful in diagnosing and determining the severity of CTS.

scholarly journals The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Fatma Gülçin Ural ◽  
Gökhan Tuna Öztürk
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Acupuncture Therapy ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Acupuncture Group ◽  
Control Group ◽  
Cross Sectional ◽  
Before And After ◽  
Tunnel Syndrome ◽  
Acupuncture Effect

Introduction. The aim of this study was to explore the acupuncture effect on the cross-sectional area (CSA) of the median nerve at the wrist in patients with carpal tunnel syndrome (CTS) and, additionally, to identify whether clinical, electrophysiological, and ultrasonographic changes show any association.Methods. Forty-five limbs of 27 female patients were randomly divided into two groups (acupuncture and control). All patients used night wrist splint. The patients in the acupuncture group received additional acupuncture therapy. Visual analog scale (VAS), Duruöz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were noted before and after the treatment in both groups.Results. VAS, DHI, Quick DASH scores, and electrophysiological measurements were improved in both groups. The median nerve CSA significantly decreased in the acupuncture group, whereas there was no change in the control group.Conclusion. After acupuncture therapy, the patients with CTS might have both clinical and morphological improvement.

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 Efficacy of Diagnosing Carpal Tunnel Syndrome Using the Median Nerve Stenosis Rate Measured on Ultrasonographic Sagittal Imagery: Clinical Case-Control Study

Hand ◽  
2021 ◽  
pp. 155894472110172
Author(s):  
Toshiyuki Okura ◽  
Tomohisa Sekimoto ◽  
Tomomi Matsuoka ◽  
Hajime Fukuda ◽  
Hiroaki Hamada ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Ultrasonographic Examination ◽  
Stenosis Rate ◽  
Tunnel Syndrome

Background The purpose of the present study was to evaluate the usefulness of the median nerve stenosis rate (MNSR) measured on sagittal sonographic images of the median nerve in the diagnosis of carpal tunnel syndrome (CTS). Methods The study population consisted of 45 hands from 37 patients with idiopathic CTS (CTS group), and 60 hands from 35 asymptomatic healthy subjects (control group). Carpal tunnel syndrome was diagnosed by clinical findings and positive electrophysiological study results. All patients and control subjects underwent ultrasonographic examination. At the carpal tunnel level, the transducer was placed longitudinally to the median nerve, and an image of the longitudinal median nerve was obtained. The minimum median nerve diameter (MND) was measured at the middle part of the capitate level, while the maximum MND was measured at the distal radioulnar joint level. The MNSR was calculated as (1 – minimum MND/maximum MND) × 100 (%). The cross-sectional area of the median nerve was also measured at the level of the pisiform. Results On longitudinal sonographic images, the MNSR was significantly larger in the CTS group than the control group. When the cut-off value of the MNSR was 26.73%, the sensitivity and specificity were 91.1% and 80%, respectively. The area under the receiver operating characteristic curve was larger for the MNSR than for the cross-sectional area. Conclusion The results suggest that the MNSR proposed in the present study may be useful as an auxiliary method for CTS diagnosis on ultrasonographic examination.

Sonographic Findings of Median Nerve and Prevalence of Carpal Tunnel Syndrome in Computer Mouse Users

2005 ◽  
Vol 18 (2) ◽  
pp. 212-220 ◽  
Author(s):  
A. Yucel ◽  
M. Yaman ◽  
M. Acar ◽  
A. Haktanir ◽  
R. Albayrak ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Computer Mouse ◽  
Tunnel Syndrome ◽  
Flattening Ratio

The purpose of this study was to evaluate the median nerve sonographically and estimate the prevalence of carpal tunnel syndrome (CTS) in computer mouse users. Forty-nine right wrists of 49 employees who had used a computer mouse were included in the study. Thirty-three right wrists of 33 non-mouse user employees were studied as a control group. Both the mouse user and non-mouse user employees underwent sonography and electromyography (EMG). Axial sonograms of the median nerve were obtained proximally, in the middle and distally in the carpal tunnel. At each level, flattening ratio and the cross-sectional area of the median nerve were calculated. We found no significant difference in any parameters between mouse users and control group ( p>0.05). However, when we compared mouse users according to the presence of pain, there was a significant increase in the cross-sectional area of the median nerve proximally in the mouse users having pain ( p<0.05). Of all mouse users, eight (16.3%) were diagnosed as sensory CTS, four (8.2%) as motor CTS by EMG. We also found that four (50%) CTS patients had a proximal cross-sectional area of median nerve exceeding 10 mm2 and five (62.5%) had a distal flattening ratio over three. Prolonged use of a mouse may pose an occupational risk for employees. Sonography can serve as an initial step in symptomatic patients for diagnosis of CTS.

scholarly journals Diagnosis Accuracy of Carpal Tunnel Syndrome in Diabetic Neuropathy

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 279
Author(s):  
Nicu Cătălin Drăghici ◽  
Maria Magdalena Tămaș ◽  
Daniel Corneliu Leucuța ◽  
Tudor Dimitrie Lupescu ◽  
Ștefan Strilciuc ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diabetic Neuropathy ◽  
Carpal Tunnel ◽  
Compound Muscle Action Potential ◽  
Ring Finger ◽  
Cross Sectional ◽  
Muscle Action Potential ◽  
The Us ◽  
Tunnel Syndrome ◽  
The Difference

Background and objectives: Carpal tunnel syndrome (CTS) is a common pathology, but sometimes the diagnosis is delayed in patients with diabetic neuropathy (DN). The aim of the study is twofold: first, to compare the accuracy of ultrasound (US) with that of electroneurography (ENG) in the diagnosis of CTS associated with DN, using the clinical diagnosis as a reference standard, and second, to investigate the correlation between morphological US parameters and electrodiagnosis (EDX) measurements in patients with CTS and DN. Materials and Methods: This study included patients with DN. They were divided into two groups: Control (patients without CTS) and Cases (patients with CTS). We performed US and ENG in both hands, totaling 56 wrists, with 28 wrists in each group. Results: We found that the difference in the sensory distal latencies between the median and the ulnar nerves (ring finger) exhibited the highest diagnostic accuracy of all the US and ENG parameters, areas under the receiver operating characteristic (AUC) = 0.99 (95% CI 0.97–1), and it was significantly different from the best US diagnostic method. The wrist cross-sectional area (CSA) had the most accurate US diagnosis, while the wrist-to-forearm ratio had the worst AUC. Moreover, in the group of CTS and DN patients, the wrist CSA enlargement was statistically directly proportional to the median compound muscle action potential (CMAP) distal latency and inversely proportional to the antidromic median nerve conduction study (NCS) and the orthodromic median palm–wrist NCS. Conclusions: Both examinations can be used with confidence in the diagnosis of CTS overlapping with DN, but the EDX examination seems to be more accurate. Furthermore, we found a positive correlation between the US and EDX parameters.

scholarly journals AB0572 CARPAL TUNNEL SYNDROME IN PATIENTS WITH PSORIATIC ARTHRITIS; ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING FINDINGS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1323.2-1323
Author(s):  
E. Akyildiz Tezcan ◽  
F. Levendoglu ◽  
M. S. Durmaz ◽  
H. Kara ◽  
E. Balevi Batur ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Psoriatic Arthritis ◽  
Magnetic Resonance ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Pearson Correlation ◽  
Control Group ◽  
Resonance Imaging ◽  
Tunnel Syndrome

Background:Carpal tunnel syndrome(CTS) is the most common form of entrapment neuropathies,caused by compression of the median nerve in the carpal tunnel at the wrist. But there is no gold standard technique for diagnosing CTS. Electrodiagnostic studies (EDS) are generally used but have some limitations. Recent years, magnetic resonance imaging(MRI) and ultrasonography(US) have facilitated the diagnosis of CTS. The median nerve cross section area(CSA) measured by US or MRI has been found to be associated with CTS[1]][2].CTS is usually idiopatic but it can be seen more in some disease. Psoriatic arthritis(PsA) occurs in up to 30% of people with psoriasis and can have serious debilitating effects on the peripheral joints, spine, tendon insertions, and fingers[3]. Because of arthritis, steroid use and flexor tenosynovitis play an important role in the pathogenesis of CTS, we think that CTS can be seen more in PsA patients.Objectives:We aimed to investigate the CTS in PsA patients with EDS, US and MRI than compare them with healthy controls.Methods:68 people, including 39 PsA (according to CASPAR criteria) and 28 healthy volunteers were included in study within 1 year. EDS, US and MRI were performed within maximum 2 weeks, and measurements were made by different doctors who were blind to other measurments. EDS was started with median and ulnar nerve motor conduction study than continued with sensory conduction studies. CTS diagnose was made according to the routine laboratory standards. The CSA measurement was made from the inner border of the hyperechoic ring around median nerve by using continuous tracing method at psiform bone level. US examinations were performed with a high frequency linear transducer (4-14 MHz), MRI examinations were performed on a 3-T imaging system. The statistical analyses were performed with Statistical Package for the Social Science Program Version 22. Descriptive statistics, T tests, chi-square test, Pearson correlation test were used.Results:No statifically significant difference was found between the groups for demographic characteristics. 12 (30.76%) of 39 PsA patients had CTS, whereas CTS was not detected in the control group(p= 0.001). US and MRI show larger CSA in PsA patients compared to the healthy control group(9,49 ± 3,00 mm2 vs 8,30 ±1,73mm2 p=0,005, 11,24 ± 3,41mm2 vs 9,35 ± 1,81mm2 p<0,001); in patients with CTS compared to others(11,63 mm2 ± 3,25 vs 8,60 ± 2,26mm2 p=0,002, 13,37 ± 3,37 mm2 vs 9,90 ± 1,58mm2 p<0,001) and in PsA patients which have CTS compared to PsA patients with normal EDS(11,63 ± 3,25 mm2 vs 8,87 ± 2,64 mm2 p=0,001, 13,37 ± 3,37 mm2 vs 10,52 ±3,15 mm2 p=0,003). When the CSA compared PsA patients which have normal EDS and healthy volunteers; US (8,87 ± 2,64 vs 8,30 ±1,73 p=0,180) and MRI (10,52 ±3,15 vs 9,35 ± 1,81 p=0,026) show larger CSA in PsA patients. But differance isn’t statistically significant for US measurments. The Pearson correlation coefficient between MRI and US measurements of the CSA was 0.85 (P<0,001).Conclusion:CTS is more common in patients with PsA. The relationship between CTS diagnosed by EDS and CSA measured by US or MRI was observed in both PsA patients and all participants. Diagnosis can be supported by US or MRI in patients who can not undergo EDS or who do not accept EDS. For PsA patients, cut off values obtained from normal people should not be used. The limitations of our study were that our CTS population was small and most of them was mild. We think that this study will be the precursor of CTS studies in PsA patients.References:[1]M. S. Cartwright et al., “Evidence-based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome,” Muscle and Nerve, vol. 46, no. 2, pp. 287–293, Aug. 2012.[2]M. Ikeda, M. Okada, M. Toyama, T. Uemura, K. Takamatsu, and H. Nakamura, “Comparison of median nerve cross-sectional area on 3-T MRI in patients with carpal tunnel syndrome,” Orthopedics, vol. 40, no. 1, pp. e77–e81, Jan. 2017.[3]C. T. Ritchlin, R. A. Colbert, and D. D. Gladman, “Psoriatic Arthritis,” N. Engl. J. Med., vol. 376, no. 10, pp. 957–970, Mar. 2017.Disclosure of Interests:None declared.

Correlation of Vitamin D Level with Electrophysiological Findings and Clinical Grading in Carpal Tunnel Syndrome

2021 ◽  
Vol 19 (7) ◽  
pp. 149-155
Author(s):  
Shatha Mohammed Abdulmunem ◽  
Hanan L. Al-Omary
Keyword(s):  
Vitamin D ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Motor Nerve ◽  
Control Group ◽  
P Value ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Clinical Grading

Carpal tunnel syndrome is a neurological disease that presented with paresthesias, pain, and numbness in the hand's median nerve compression. Vitamin D was assumed to affect both electrophysiological &clinical gradings, the study aims to assess the correlation between the deficiency of vitamin D and both electrophysiological and clinical gradings. This study was conducted in Ghazi Alhariri Hospital during the period from the first of November/2020 to the twenty-eighth of February/2021, fifty five individuals were referred to as Carpal tunnel syndrome patients, and compared to (55) control individuals, blood samples were withdrawn from the patients (3ml), centrifuged and kept in the freezer (-20°C) until the time of analysis of vitamin D3, Sensory and motor nerve conduction studies of both median and ulnar nerve were done bilaterally. patients were classified electrophysiologically and clinically into two subgroups (mild to moderate) and (severe) groups. The result showed that the differences are not significant in the gender, BMI and vitamin D of the patients versus the control group (p>0.05), the difference of the electrophysiological parameters was not significant between patients with low vitamin D versus those with normal vitamin D (p value>0.05), there was a significant association between the electrophysiological and clinical grading in addition to a significant association between vitamin D level and the clinical grading. Vitamin D deficiency does not affect the electrophysiological parameters while the clinical grading becomes worse with the decrease in its level. The electrophysiological grading is associated with clinical grading.

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