We analyze the effectiveness of ultrasonography in diagnosing carpal tunnel syndrome (CTS) and propose the use of sonographic index of median nerve (MN) in carpal tunnel (SIMNCT) in a diagnostic algorithm and in establishing a scale of severity.
We studied a group of 344 patients with CTS symptoms, examining them by ultrasound. We measured in all patients, on the affected hand: the size of the cross-sectional area of the MN at carpal tunnel (CT) inlet and outlet, nerve morphology at passage through CT, the vertical thickness of the MN entering into the CT – G1, the lowest vertical thickness into the CT or leaving the CT – G2, the thickness of the MN in the transversal plane as entering in the CT – L. Normal values were considered the similar measurements taken on the healthy hand and we established as normal SIMNCT = 16%. We proposed the formula SIMNCT = 100% (1-G2/G1) in order to calculate the index.
Statistics show a significant sensitivity of SIMNCT (
P
< .0001) compared with cross-sectional area (CSA) and flattening ratio in the diagnosis of CTS. Analyzing the SIMNCT developed by us, we demonstrated a sensitivity of 94.81% and a specificity of 99.66% in CTS diagnosis. Thereby, we propose a CTS severity classification: normal = 16%, mild = 16–19%, moderate = 19% to 28%, severe = 28% to 50%, very severe > 50%.
Ultrasonography is an effective method of studying the morphology of the tunnel and compressed nerve at various CTS stages and determining the cause of compression. The SIMNCT is a valuable and practical indicator and it can be used in the CTS diagnosis.
Drug-induced immune thrombocytopenia is a frequent condition among hospitalized patients and is hard to diagnose because of the ambiguity of etiologies. It can lead to severe complications. We present a case of a 35-yearold male who was recently treated for infective endocarditis, now presenting with cellulitis. He was treated with cefazolin, a first-generation cephalosporin and later on developed severe thrombocytopenia. The diagnosis was difficult since our patient had multiple conditions that could explain his thrombocytopenia. This is one of the few reported cases of cefazolin-induced thrombocytopenia where we also discuss etiology, workup, and treatment in detail.
Scopul acestui studiu a fost de a compara rezultatele clinice, funcționale și radiologice ale tehnicii MIPO pentru fixarea internă a humerusului cu reducerea deschisă și fixarea internă pe o perioadă de urmărire de 12 luni. Evaluarea complicațiilor postoperatorii, a rezultatelor și a vindecării la pacienți după intervenția MIPO. Analiza stării clinice, subclinice și de tratament a pacienților cu defect osos humeral la Institutul de Medicină de Urgență în 2022
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.