Diagnostic Precision of Ultrasonography in Patients with Carpal Tunnel Syndrome

Keleş, Işık; Kendi, Ayşe Tuba Karagülle; Aydın, Gülümser; Zöğ, S Gülfer; Orkun, Sevı̇m

doi:10.1097/01.phm.0000163715.11645.96

Cited by 71 publications

(59 citation statements)

References 21 publications

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“…For the determination of the optimal position on which the median nerve is most comfortable, there are catheter applications in which the intracarpal pressure is evaluated and MRI and US studies in which the AP diameter, transverse diameter and flattening ratio of the median nerve are evaluated [7][8][9][10][11][12][13][14][15][16][17]. In a study in which the CT pressure was evaluated in 20 healthy subjects, the CT pressure at 30°e xtension configuration of the wrist was found to be significantly higher when compared to 15°flexion and neutral (0°) configurations, whereas it was found to be significantly higher at 45°extension when compared to all the other angles [7].…”

Section: Discussionmentioning

confidence: 99%

“…Studies in which the median nerve is evaluated by MRI and US, and CT pressure is determined by using intracarpal catheter can be found in the published literature [7][8][9][10][11][12][13][14][15][16][17]. Recent research has shown that evaluation by ultrasound is promising for making CTS diagnosis [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Recent research has shown that evaluation by ultrasound is promising for making CTS diagnosis [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

et al. 2010

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To evaluate the clinical effectiveness of wrist splint usage arranged by determining the optimal position on which the median nerve is compressed the least through sonographic examination for patients with carpal tunnel syndrome (CTS). This study was a prospective, clinical trial with a 6-week follow-up. Twenty-four patients diagnosed clinically and electromyographically with CTS were included in the study. A total of 37 wrists were studied on. When the patients were grouped according to the optimal position, Group I comprising 16 (43.24%) wrists was at 15 degree flexion, Group II comprising 12 (32.43%) wrists was neutral, Group III comprising 6 (16.22%) wrists was at 15° extension and Group IV comprising 3 (8.11%) wrists was at 30° extension configurations. Groups I, II and III were included in clinical follow-up. Symptom severity score (SSS), functional status score (FSS), Grip strength and Pinch strength were used for the clinical follow-up and evaluation of the patients. When pre- and post-treatment were compared, a statistically significant recovery was detected in all three groups in respect to SSS (Group I P < 0.01, Group II P < 0.05, Group III P < 0.05). A statistically significant recovery was detected for FSS only in Group I (P < 0.05) and for Grip strength in Group II (P < 0.05). When the groups were compared among themselves, no statistically significant difference was detected for any of the parameters (P > 0.05). In this study, by sonographic examination of the patients included in the study with CTS, we saw that the optimal position on which the median nerve is compressed the least varies depending on the individual and we determined that this position was 15° flexion most frequently for our patients. We also observed that in clinical follow-up of wrist splint usage arranged on custom optimal position results in significant recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

et al. 2010

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“…Nevertheless the demonstrated cut-off values of the CSA measurements of the median nerve range between 9-12 mm 2 with sensitivities between 73.4-99% and specificities between 57.1-100% among different studies [9,[30][31][32][33][34]. These inconsistencies could be related to the measurement of the CSA of the median nerve at different levels as well as the selection of the study sample, since age, gender, and ethnic group may affect the thickness of the median nerve.…”

Section: Rte Measurements Sr Measurements At the Level Of Carpal Tunnmentioning

confidence: 85%

Carpal tunnel syndrome: elastosonographic strain ratio andcross-sectional area evaluation for the diagnosis and disease severity.

et al. 2016

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Aim: To evaluate the role of gray scale ultrasonography (US) and real time elastosonography (RTE) in carpal tunnel syndrome (CTS). Materials and methods: Both wrists of 18 healthy volunteers (n=36) formed the control group (Group 1) and 19 symptomatic outpatients of the neurology clinic constituted the patient group. According to nerve conduction study results, cases with mild CTS (n=15) formed Group 2; cases with moderate to severe CTS (n=20) formed Group 3. Cross sectional area (CSA) and strain ratio (SR) were measured at carpal tunnel inlet (CTI) and 4 cm proximal to the distal end of the radius (P). CSA and SR change score (CSA CTI -CSA P ; SR CTI -SR P ), CSA and SR ratio score (CSA CTI / CSA P ; SR CTI / SR P ) were calculated.

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“…It is well-established that anthropometric data varies among different populations. The cutoff point in the current study was 0.4 ms (distal sensory latency of the median nerve minus the distal sensory latency of by electro-diagnostic testing [14]. The prevalence rates of CTS may vary according to the diagnostic tools used.…”

Section: Ijomeh 2017;30(2) 287mentioning

confidence: 99%

Postures of upper extremity correlated with carpal tunnel syndrome (CTS)

Chiang

Liao

Kuo³

2017

Int J Occup Med Environ Health

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Objectives: Non-medical hospital staff members are in frequent contact with patients and therefore are required to perform a wide variety of repetitive and high-frequency activities. The objective of this study was to assess the relationships between upper extremity activity and carpal tunnel syndrome (CTS) among non-medical hospital staff members. Material and Methods: Carpal tunnel syndrome in 144 non-medical hospital staff members was diagnosed using the Nordic Musculoskeletal Questionnaire (NMQ), a physician's diagnosis, physical examination (Tinel's signs and Phalen test) and a nerve conduction velocity (NCV) test. In addition, an ergonomic assessment was performed and a video camera was used to record the physical activities at work. Results: The prevalence rate of CTS was highest for the NMQ (51.9%), followed by physician's diagnosis (49.5% for the right hand, 29.9% for the left hand), physical examination (54.7%), and nerve conduction test (motor nerve 27.5% and 25%, sensory nerve 21.7% and 15%, for right and left hands, respectively). Based on logistic regression models for the NMQ and physician's diagnoses, there was a dose-dependently higher risk of CTS with the upper extremity index among participants, but this was non-significant based on the physical examination and nerve conduction tests. Conclusions: Nerve conduction velocity is the gold standard in diagnosis of CTS, but use of NMQ and physician's diagnosis may overestimate the incidence of CTS in workers who have been engaging in repetitive stress activities for a relatively short time. Int J Occup Med Environ Health 2017;30(2):281-290

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Diagnostic Precision of Ultrasonography in Patients with Carpal Tunnel Syndrome

Cited by 71 publications

References 21 publications

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

Carpal tunnel syndrome: elastosonographic strain ratio andcross-sectional area evaluation for the diagnosis and disease severity.

Postures of upper extremity correlated with carpal tunnel syndrome (CTS)

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