scholarly journals Median nerve ultrasonography examination correlates with electrodiagnostic studies for the diagnosis of moderate to severe carpal tunnel syndrome

2021 ◽  
Author(s):  
Pavel Potuznik ◽  
Petr Hosek ◽  
Rudolf Kotas
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Tunnel Syndrome ◽  
Nerve Ultrasonography

Hydrodissection by median nerve ultrasonography for treatment of carpal tunnel syndrome. Case reports

2020 ◽  
Vol 3 ◽  
Author(s):  
Estevão dos Santos Diniz ◽  
Carlos M Barros ◽  
Venâncio L Pereira ◽  
Vittoria C Fares
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Case Reports ◽  
Tunnel Syndrome ◽  
Nerve Ultrasonography

scholarly journals The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment

2018 ◽  
Vol Volume 13 ◽  
pp. 1953-1962 ◽  
Author(s):  
Reza Salman Roghani ◽  
Seyed Ebrahim Hashemi ◽  
Mohammad Taghi Holisaz ◽  
Faeze Gohari ◽  
Ahmad Delbari ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Elderly Patients ◽  
Diagnostic Accuracy ◽  
Median Nerve ◽  
Sensitivity And Specificity ◽  
Carpal Tunnel ◽  
Tunnel Syndrome ◽  
Nerve Ultrasonography

Median Nerve Ultrasonography Measurements Correlate With Electrodiagnostic Carpal Tunnel Syndrome Severity

2019 ◽  
Vol 27 (1) ◽  
pp. e17-e23 ◽  
Author(s):  
Beverlie L. Ting ◽  
Philip E. Blazar ◽  
Jamie E. Collins ◽  
Ariana N. Mora ◽  
Mohammad Kian Salajegheh ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Tunnel Syndrome ◽  
Nerve Ultrasonography

scholarly journals SENSITIVITY AND SPECIFICITY OF MEDIAN NERVE ULTRASONOGRAPHY IN DIAGNOSIS OF CARPAL TUNNEL SYNDROME

2021 ◽  
pp. 1-4
Author(s):  
Maripi Gnani ◽  
Sirisha Naidu ◽  
Ch. Madhavi ◽  
G.S. Kejriwal
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Sensitivity And Specificity ◽  
Cross Section ◽  
Cross Sections ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Gold Standard ◽  
Tunnel Syndrome ◽  
Nerve Ultrasonography

Background: Although controversial, recent studies have demonstrated advantages of sonographic techniques in the diagnosis of carpal tunnel syndrome (CTS). The purpose of this study was to assess the utility of median nerve ultrasonography in the diagnosis of CTS in Indian patients. Methods: Ninety patents with clinically suspected CTS were studied. Based on gold standard electromyography/nerve conduction ve-locity studies, wrists with CTS were divided into three groups on the basis of severity of CTS, ie, mild, moderate, and severe. In addition, both sides of the wrist were examined using sonography. Transverse images of the median nerve were obtained and median nerve cross-section areas were measured at three levels, ie, immediately proximal to the carpal tunnel inlet, at the carpal tunnel inlet, and at the carpal tunnel outlet. Furthermore, flexor retinaculum thickness was evaluated. Results: The mean age of the studied patients was 48.52  12.17 years. Median values of the median nerve cross-section at the carpal tunnel in-let, carpal tunnel outlet, and proximal carpal tunnel significantly differed between the wrists with and without CTS (P < 0.05). Comparisons be-tween the CTS groups (mild, moderate, and severe) and non-CTS wrists demonstrated that the median cross-sections of median nerve at the carpal tunnel inlet, carpal tunnel outlet, and inlet proximal carpal tunnel were significantly greater in the severe CTS group than in the other three groups (P < 0.05). The results showed that the median nerve cross-section at the three levels of carpal tunnel could only fairly differentiate se-vere CTS from other cases. Conclusion: The present study demonstrated that median nerve ultrasonography cannot replace the gold standard test (nerve conduction velocity) for the diagnosis of CTS because of low overall sensitivity and specificity, although it might provide useful information in some patients.

scholarly journals POS0584 ULTRASONOGRAPHY OF THE MEDIAN NERVE IN PATIENTS WITH RHEUMATOID ARTHRITIS UNDER SUSPICION OF CARPAL TUNNEL SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 525.1-525
Author(s):  
S. Tsiami ◽  
E. Ntasiou ◽  
C. Krogias ◽  
R. Gold ◽  
J. Braun ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction Velocity ◽  
Sectional Area ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Tunnel Syndrome

Background:Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome and a common extra-articular manifestation of rheumatoid arthritis (RA). Different causes of CTS are known, among them inflammatory and non-inflammatory pathologies. Electroneurography (ENG) of the median nerve, the method of choice to diagnose CTS, measures impairment of nerve conduction velocity without explaining its underlying cause. However, because the electrical stimulation is often not well tolerated, ENG results may come out inconclusive. Using greyscale ultrasonography (GS-US) provides anatomic information including a structural representation of the carpal tunnel.Objectives:To investigate the performance of nerve GS-US in the diagnosis of CTS in patients with RA.Methods:Consecutive patients with active RA under suspicion of CTS presenting to a large rheumatologic center were included. Both hands were examined by an experienced neurologist including ENG and a GS-US (ML linear probe with 6-15 Hz) of the median nerve. An established grading system for ENG (1), and an established system for GS-US based on cut-offs for the nerve cross sectional area (CSA) [mild: 0,11-0,13cm2, moderate: 0,14-0,15 cm2, severe: > 0,15 cm2 CTS (2)] were used. In addition, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) was used to assess CTS symptoms (3).Results:Both hands of 58 patients with active RA (n=116) and clinical suspicion of CTS (in 38 cases bilaterally) were included. After clinical examination, CTS was suspicious in 96 hands (82.8%), and 59 of all hands had a final diagnosis of CTS (50.9%). Of the latter, 43 hands (72.9%) had a positive ENG and 16 (27.1%) a positive GS-US finding only, while 30 hands (50.8%) were positive in both examinations.There was a good correlation of the cross-sectional area (CSA) as well as the CSA-ratio to the ENG findings: the larger the CSA, the more severe was the CTS as assessed by ENG (Spearman’s rho=0.554; p<0.001). The more severe the GS-US findings of CTS were, the more definite were the distal motor latency (Spearman’s rho=0.554; p<0.001) and sensible nerve conduction velocity of the median nerve (Spearman’s rho=-0.5411; p<0.001).In the 46 hands positive in GS-US, tenosynovial hypertrophy of the flexor tendons was detected in 19 hands (41.3%), 7 of which (36.8%) also showed an additional cystic mass. In these 19 patients, clinical complains were more severely present than in patients with non-inflammatory CTS, as assessed by the BCTSQ with a total score of 68.8±13.4 vs. 59.3±13.7, respectively (p=0.007).Conclusion:In patients with active RA and clinical complains of CTS, ultrasound examinations provide additional information about inflammation which is helpful for a diagnosis of CTS. Thus, ENG and nerve GS-US should be used complementary for a diagnostic workup of CTS in RA patients with a suspicion of CTS. Power-Doppler may further improve the diagnostic performance of GS-US.References:[1]Padua L et al. Acta Neurol Scand 1997; 96:211–217[2]El Miedany et al., Rheumatology (Oxford). 2004 Jul; 43(7):887-895[3]Levine DW et al. J Bone Joint Surg Am 1993; 75: 1585-1592Figure 1.BCTSQ scores in patients with diagnosis of CTS and absence or presence of RA-related tenosynovial hypertrophyDisclosure of Interests:None declared

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