Comparing a New Ultrasound Approach with Electrodiagnostic Studies to Confirm Clinically Defined Carpal Tunnel Syndrome

Claes, Franka; Kasius, Kristel M.; Meulstee, J.; Verhagen, W. I. M.

doi:10.1097/phm.0b013e31829b4bd8

Cited by 35 publications

(39 citation statements)

References 16 publications

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“…17 In early stages, these morphologic changes may exist before the nerve damage occurs that can be picked up by electrodiagnostic evaluations. 18,19 Once physiological changes progress beyond electrodiagnostic thresholds, the continued increase in CSA has been correlated positively with severity classification. 8,20 Similarly, intraneural vascularity may be useful for identifying stages and severity of CTS.…”

Section: Introductionmentioning

confidence: 99%

Carpal tunnel syndrome severity staging using sonographic and clinical measures

et al. 2015

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Introduction Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures. Methods Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness-of-fit was evaluated for models using iterative combinations of highly correlated variables. Using the best-fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated. Results The severity staging model with best fit (Rho 0.90) included patient-reported symptoms, functional deficits, provocative testing, nerve cross-sectional area, and nerve longitudinal appearance. An 8-point scoring scale classified severity accurately for 79.8% of participants. Discussion This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model.

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Section: Introductionmentioning

confidence: 99%

Carpal tunnel syndrome severity staging using sonographic and clinical measures

et al. 2015

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“…Cross‐sectional area measurement is a well‐established method, and the results of this study showed that the patients with acromegaly had an increased cross‐sectional area compared with the healthy control group, which provides an insight into median nerve morphologic characteristics. Lack of electrodiagnostic testing might be considered a limitation of this study, although electromyographic findings have previously been reported to be correlated with US findings …”

Section: Discussionmentioning

confidence: 90%

Ultrasound Elastography of the Median Nerve in Patients With Acromegaly: A Case‐Control Study

Burulday

Doğan

Şahan

et al. 2018

J of Ultrasound Medicine

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“…At present, CTS patients associated with ulnar nerve involvement do not receive sufficient attention. Nevertheless, a neurophysiological approach is the most sensitive method for evaluating peripheral nerve compression damage (Claes et al, 2013). In the present study, we classified the CTS severity of all patients including those with and without fifth digit symptoms by using neurophysiological methods.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome

Zhang¹,

Liu²,

Wang³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory. Electrophysiological studies were conducted in CTS patients and healthy controls. CTS patients were divided into the mild/moderate group and severe group; they were further divided into the symptomatic and asymptomatic subgroups according to the sensory symptom of the fifth digit region. The findings suggest that CTS patients could have coexisting ulnar nerve wrist entrapments that might exacerbate the severity of CTS. Sensory impairment in the ulnar territory was observed more frequently in the mild/moderate stage of CTS, which is associated with ulnar nerve involvement. These findings also suggest that damage Ulnar nerve in carpal tunnel syndrome to the ulnar nerve fibers caused by compression forces in Guyon's canal may underlie the ulnar spread of symptoms in CTS.

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Comparing a New Ultrasound Approach with Electrodiagnostic Studies to Confirm Clinically Defined Carpal Tunnel Syndrome

Cited by 35 publications

References 16 publications

Carpal tunnel syndrome severity staging using sonographic and clinical measures

Carpal tunnel syndrome severity staging using sonographic and clinical measures

Ultrasound Elastography of the Median Nerve in Patients With Acromegaly: A Case‐Control Study

Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome

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