Objective. Sonographic examination of the median nerve has been suggested as a useful alternative to electrophysiologic study in the diagnosis of carpal tunnel syndrome. To determine its usefulness and the best diagnostic criterion, sonograms of patients with the disease were compared with sonograms of healthy subjects in a case-control study.Methods. Patients with carpal tunnel syndrome and asymptomatic controls who were matched for age and sex were enrolled and underwent sonography of the wrists. Eight separate sonographic criteria were analyzed in each wrist. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome, using receiver operating characteristic analytic techniques.Results. Thirty-five patients with carpal tunnel syndrome and 35 asymptomatic controls were examined. Increased cross-sectional area of the median nerve was found to be the most predictive measure of carpal tunnel syndrome, proximal to the tunnel inlet, at the tunnel inlet, and at the tunnel outlet, with significant differences between patients and controls. Using a receiver operating characteristic curve, a cut-off value >0.098 cm 2 at the tunnel inlet provided a diagnostic sensitivity of 89% and a specificity of 83%.Conclusion. Sonographic measurement of the median nerve cross-sectional area is both sensitive and specific for the diagnosis of carpal tunnel syndrome.A diagnosis of carpal tunnel syndrome (CTS) is usually based on symptom characteristics and confirmatory neurophysiologic evaluation (1). Sonographic examination of the median nerve in CTS has been proposed as a useful alternative to neurophysiologic study in the diagnosis of CTS, and proposals for different criteria have been presented (2-7), as summarized in Table 1. The lack of consensus on the optimal criteria for CTS may be attributable to differences in equipment, patient populations, and sonographic techniques. These discrepancies underscore the need for each center to validate internally the criteria it uses to diagnose CTS with ultrasound.This study aimed to prospectively evaluate the characteristics of the median nerve in CTS patients against the findings in normal, healthy subjects, to elicit the optimal discriminatory sonographic criteria and relevant threshold values. PATIENTS AND METHODSCases and controls. This was a prospective, agematched case-control study of CTS in a cohort comprised solely of women, since women account for the majority of CTS patients in the local population (8). The study ethics were reviewed and approved, and patients gave their written informed consent. Consecutive CTS patients from our neurology and rheumatology clinics were invited to join the study. Patients were enrolled into the study after electrophysiologic examination, if the following criteria were fulfilled: 1) presence of sensory symptoms over the median nerve distribution, and 2) confirmatory neurophysiologic results (prolonged median nerve distal motor latencies Ͼ4 ms or a median-ulnar palmer sensory ...

The authors compared the effectiveness of low-dose, short-term oral prednisolone vs local methylprednisolone injection in a prospective, double-blinded, parallel treatment study of carpal tunnel syndrome (CTS). A single injection of 15 mg methylprednisolone resulted in significant improvement in global symptom scores over a 12-week period. This study demonstrated the superiority of local steroid injection to oral steroid in the treatment of CTS.

We report acute encephalopathy associated with influenza A infection in 3 adults. We detected high cerebrospinal fluid (CSF) and plasma concentrations of CXCL8/IL-8 and CCL2/MCP-1 (CSF/plasma ratios >3), and interleukin-6, CXCL10/IP-10, but no evidence of viral neuroinvasion. Patients recovered without sequelae. Hyperactivated cytokine response may play a role in pathogenesis.

We report acute encephalopathy associated with infl uenza A infection in 3 adults. We detected high cerebrospinal fl uid (CSF) and plasma concentrations of CXCL8/IL-8 and CCL2/MCP-1 (CSF/plasma ratios >3), and interleukin-6, CXCL10/IP-10, but no evidence of viral neuroinvasion. Patients recovered without sequelae. Hyperactivated cytokine response may play a role in pathogenesis.

The purpose of this study was to investigate the long-term prognosis of patients with carpal tunnel syndrome (CTS). We prospectively followed-up patients with CTS for 80 weeks. Thirty cases had been treated with a single injection of methylprednisolone acetate and another 30 with a 10-day course of prednisolone. At the end of the follow-up period, there were no significant differences in symptoms as measured by global symptom score and in the proportion of patients who progressed to decompressive surgery. Few patients who were not operated on (11.4%) remain asymptomatic.