Diagnosis of Carpal Tunnel Syndrome

Lee, Doohi; Holsbeeck, Marnix van; Janevski, Peter; Ganos, Doreen L.; Ditmars, Donald M.; Darian, Vigen

doi:10.1016/s0033-8389(05)70132-9

Cited by 227 publications

(62 citation statements)

References 17 publications

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“…[13] The abrupt change in nerve caliber at the entrance of carpal tunnel is called “notch sign” [Figure 11A and B]. [14] The nerve may show a homogeneous hypoechoic appearance with loss of fascicular echopattern [Figure 12A and B]. On dynamic examination, there is reduced transverse sliding movement in some cases.…”

Section: Entrapment Neuropathiesmentioning

confidence: 99%

Role of ultrasound in evaluation of peripheral nerves

Lawande

Warrier

Joshi

2014

Indian Journal of Radiology and Imaging

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Ultrasonography (USG) is an excellent cost-effective modality in imaging of peripheral nerves. With the newer high-frequency probes with different footprints which allow high-resolution imaging at relatively superficial location, USG can detect and evaluate traumatic, inflammatory, infective, neoplastic, and compressive pathologies of the peripheral nerves. This article describes the technique for evaluation of nerves by USG as well as the USG appearances of normal and diseased peripheral nerves.

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Section: Entrapment Neuropathiesmentioning

confidence: 99%

Role of ultrasound in evaluation of peripheral nerves

Lawande

Warrier

Joshi

2014

Indian Journal of Radiology and Imaging

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“…These four MR findings are now widely accepted, although they can be nonspecific and observed in asymptomatic individuals [53]. There are various causes of carpal tunnel syndrome, including rheumatoid arthritis, gout, calcium pyrophosphate deposition, acromegaly, hypothyroidism, amyloidosis, neoplasm, ganglion, thrombosis of the median artery, fibrosis of tendons, skeletal anomaly, hemorrhage, and trauma; however, in many cases, the exact etiology remains unidentified [54]. MR imaging can help to identify the causes of carpal tunnel syndrome (Fig.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity

et al. 2006

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The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging.

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“…Considering that edema of the nerve is a feature of CTS it follows that the cross-sectional area would be affected, but determining exactly what value is a threshold for CTS requires insight into the normal reference range of the diameter of the nerve, and this is a controversial issue. Different studies have suggested different values for the normal range: 8.5, 9 to 12 (16-18) and even 15 mm 2 (19). In the present study, without consideration of different variables and as a customary rule, the normal range was considered as 8.70 ± 1.56.…”

Section: Discussionmentioning

confidence: 99%

Presence or Absence of Palmaris Longus and Fifth Superficial Flexor Digitorum; Is There Any Effect on Median Nerve Surface Area in Wrist Sonography

et al. 2014

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Background:Carpal tunnel syndrome (CTS) describes a set of symptoms caused by compression of the median nerve in the wrist, which is the most common site of nerve compression in the upper limb. This syndrome is a primary source of pain and reduced function in these patients, and the cause is compression of the median nerve where it passes beneath the flexor retinaculum in the wrist.Objectives:The aim of the present cross sectional study is to assess the absence of palmaris longus and fifth superficial flexor digitorum tendon as normal anatomic variations on the sonographic measurement of median nerve surface area in healthy individuals’ wrists.Patients and Methods:Ninety-three healthy volunteers underwent clinical evaluation for determining the presence of tendons in both wrists and sonographic measurement of median nerve surface area.Results:In 41 of 186 (22%) hands, the palmaris longus tendon was absent and absence of the fifth flexor digitorum tendon was noted in eight (4.30 %). The median surface area in the hands without palmaris longus was meaningfully lower than the hands with it (P = 0.025), while the difference in the median surface area was not statistically significant with regard to presence of the fifth flexor digitorum tendon (P = 0.324).Conclusions:Based upon the findings of the present study, it seems that the median surface area as a sonographic finding is probably related to presence or absence of the palmaris longus tendon, so that hands with the tendon present have larger surface areas. In addition, it seems that this sonographic finding does not depend on the function of the fifth superficial flexor digitorum tendon. Therefore, no correlation between CTS and the presence of palmaris longus tendon should be observed.

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Diagnosis of Carpal Tunnel Syndrome

Cited by 227 publications

References 17 publications

Role of ultrasound in evaluation of peripheral nerves

Role of ultrasound in evaluation of peripheral nerves

Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity

Presence or Absence of Palmaris Longus and Fifth Superficial Flexor Digitorum; Is There Any Effect on Median Nerve Surface Area in Wrist Sonography

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