Carpal tunnel changes and median nerve compression during wrist flexion and extension seen by magnetic resonance imaging

Skie, Martin; Zeiss, Jacob; Ebraheim, Nabil A.; Jackson, William T.

doi:10.1016/0363-5023(90)90019-n

Cited by 85 publications

(57 citation statements)

References 15 publications

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“…Before entering the carpal tunnel, it gives off the palmar superficial branch that courses outside the carpal tunnel. When traced distally, the median nerve flattens at the level of the os hamatum and it gives its branches near the distal exit (9,11,19).…”

Section: Introductionmentioning

confidence: 99%

“…Its long axis is parallel to the flexor retinaculum in most cases. As it is traced distally, median nerve divides into its terminal branches and this anatomical formation can be seen in the most distal part of the carpal tunnel at the level of metacarpal bases (9,15,19).…”

Section: Introductionmentioning

confidence: 99%

“…These findings with the complement of EMG can be supportive to the diagnosis. On the other hand, MR findings depend on the comments of the radiologist as there is no parametric value differentiating normal and pathologic wrists, contrary to EMG (9,10,12,15,19). The aim of this study was to try to find parametric ratios to explain the pathophysiology of carpal tunnel syndrome using MR.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative MRI analysis of idiopathic carpal tunnel syndrome

Oge¹,

Acu²,

Gucer³

et al. 2012

Turkish Neurosurgery

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ABSTRACTaIM: The aim of this study was to try to find parametric ratios for the diagnosis and pathophysiology of carpal tunnel syndrome using MR. MaterIaL and MetHOds:Dominant side wrist MRI examinations of 27 female carpal tunnel patients and 21 normal females were compared. The carpal tunnel contents area / carpal tunnel cross section area ratio was defined, analysed and discussed with the literature. resuLts: Carpal tunnel contents / wrist area ratios of the carpal tunnel patients were measured and compared with the control group. This comparison revealed that the proportion of the contents of the carpal tunnel is increased in the carpal tunnel syndrome patients. Palmar bowing was found to be increased and median nerve cross section area was found to be increased at the proximal entrance of the carpal tunnel.cOncLusIOn: As Phalen has postulated, the volume of the contents of the carpal tunnel were found to be increased in the carpal tunnel syndrome patients. Carpal tunnel cross section areas remained the same with the control group. This increase can be demonstrated by MRI imaging which can provide an evidence for the pathophysiology of carpal tunnel syndrome.keywOrds: Carpal tunnel syndrome, Area measurement, Ratio ÖZ aMaÇ: Bu çalışmanın amacı, el bileği MR incelemesiyle tespit edilen karpal tünel kapsamı/karpal tunel alanı oranları ile karpal tunel sendromuna diagnostik ve patofizyolojik bir yaklaşımda bulunmaktır. yÖnteM ve gereÇLer: 27 karpal tunel hastası kadın ile dominant el bileği MR incelemesi yapılan 21 kadından oluşan kontrol grubunun el bilek MR ları karşılaştırılmıştır. Karpal tunel kapsamı / karpal tunel alanı oranı tanımlanarak bu oran, median sinir alanı ve transverse karpal ligamentteki palmar yaylanma ölçülerek analiz edilmiştir.BuLguLar: Seride karpal tunel kapsamı/karpal tunel alanı oranında karpal tunel sendromlu hastalarda karpal tunel kapsamı lehinde istatistiksel olarak anlamlı bir artış tespit edilmiştir. Hastalarda karpal tunel proksimal girişinde ölçülen median sinir kesit alanlarında ve transvers karpal ligament palmar yaylanmasında da istatistiksel olarak anlamlı bir artış bulunmuştur. sOnuÇ: Karpal tunel sendromlu hastalarda Phalen'in öne sürdüğü gibi karpal tunel kapsamında kronik travmaya bağlı bir artış tespit edilmiştir. Bu kapsam artışına karşılık karpal tunel yüzey alanlarında anlamlı bir artış tespit edilmemiştir. Bu bulgu MR ile gösterilebilmektedir ve karpal tunel sendromunun fizyopatolojisinin anlaşılması konusunda bir kanıt olabilmektedir.anaHtar sÖZcÜkLer: Karpal tunel sendromu, Alan ölçümü, Oran

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantitative MRI analysis of idiopathic carpal tunnel syndrome

Oge¹,

Acu²,

Gucer³

et al. 2012

Turkish Neurosurgery

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“…Skie et al [13] measured average cross-sectional areas of the carpal tunnel at the level of the hook of hamate and found a mean of 152 mm 2 . Allman et al [1] found similar numbers in their MRI study, with mean cross-sectional areas of 152 mm 2 again at the level of the hamate and 178 mm 2 at the level of the pisiform.…”

Section: Introductionmentioning

confidence: 99%

Morphological Analysis of the Carpal Tunnel

Pacek

Tang

Goitz

et al. 2009

Hand (New York, N,Y.)

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Although carpal tunnel release is one of the most commonly performed procedures in the USA, the morphology of the carpal tunnel as determined previously in the literature has been questioned. Previous methodology has been questioned for accuracy by recent studies. The purpose of this study was to perform a morphological analysis of the carpal tunnel and correlate carpal tunnel and hand dimensions. The carpal tunnels of ten cadaveric specimens were emptied of their contents and a silicone cast of the carpal tunnel was then created. This cast was then digitized, and the dimensions of the carpal tunnel were calculated. These dimensions were compared with the measured hand dimensions of the specimens. The width, depth, tilt angle, length, cross-sectional area, and volume of the carpal tunnel were 19.2 ± 1.7 mm, 8.3 ± 0.9 mm, 14.8 ± 7.8°, 12.7 ± 2.5 mm, 134.9 ± 23.6 mm 2 , and 1,737 ± 542 mm 3 , respectively. Width, depth, and cross-sectional area did not change significantly along the length of the carpal tunnel, but tilt angle did. The width of the palm strongly correlates with the width of the carpal tunnel. Other dimensional correlations did not reach statistical significance. The carpal tunnel is of uniform dimension along its length. The long axis of the carpal tunnel in cross-section rotates volarly from the radial side of the hand increasingly with distal progression along the carpal tunnel. Based on our analysis of ten cadaveric specimens, the width of the carpal tunnel may be estimated by the width of the palm using the equation: Width CT ¼ 1:285 þ 0:236 Â Width palm .

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“…CT syndrome, which results from an increased pressure in the CT [9], is the most common nerve entrapment syndrome in clinical practice [2,4,19].…”

Section: Introductionmentioning

confidence: 99%