Idiopathic Carpal Tunnel Syndrome: Evaluation of the Depth of the Carpal Tunnel by Ultrasonography

Elsaman, Ahmed M.; Thabit, Mohamed N.; Radwan, Ahmed; Ohrndorf, Sarah

doi:10.1016/j.ultrasmedbio.2015.06.018

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…In this study, females markedly outnumbered males (2:1) in the CTS patients' group. This is line with previous Egyptian studies including that of El Miedany et al, Elsaman et al and Razek et al [22,23,24].…”

Section: Discussionsupporting

confidence: 93%

Are Carpal Tunnel Syndrome and Migraine Related?

Esmael

Gomaa

Hazem

2019

INDJ

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Background: Compression neuropathies have previously been associated with one another. Migraine has not been considered a type of compression neuropathy but, some recent studies found that some types of migraines may be treated by targeted peripheral nerve decompression. So, the association between migraines and carpal tunnel syndrome (CTS), {the most common compression neuropathy} may exists. Objective: The aims of this study are to found whether there is a relationship between carpal tunnel syndrome and migraine, and if so to determine the factors causing this relationship. Methods: The present study is a cross-sectional case control study of 120 patients with CTS in addition to age and sex matched 120 healthy controls. It was conducted at Mansoura University Hospitals, Egypt in the period from July, 2017 through June, 2018. All subjects underwent neurological examination, nerve conduction study of median nerve bilaterally, and evaluation according to headache by the International Headache Society, 2016 criteria. Also, the clinical severity of CTS was assessed and calculation of body mass index (BMI) was done. Evaluation of patients by Boston questionnaire form (BQF) {composed of two parts, Symptom Severity Scale (SSS) and the Functional Status Scale (FSS)}. Lastly, assessment of patients by Beck Depression Inventory (BDI). Results: Patients had significantly higher rates of migraine headache (28.3 %) either alone (17.5 %) or combined with tension headache (10.8 %) when compared to controls. No statistically significant differences were found between the studied groups regarding the frequency of isolated tension headache. However, the total rate of cases with tension headache (n=43) including those in association with migraine is significantly higher in patients when compared to controls. Patients had significantly higher rates of various grades of symptoms severity. All patients but 17 are functionally affected while none of the controls group is affected. Patients had significantly higher rates of borderline and moderate depression when compared to controls. Univariate logistic regression analysis for predictors of migraine headache in the studied patients shows that, older age (P value = 0.0001), female sex (P value = 0.003), being manual worker (P value = 0.005), obesity class 11 (P value = 0.023), very severe functional severity scale (P value = 0.001), borderline and moderate depression (P value = 0.008 and 0.002 respectively) were significant predictors of migraine. Conclusion: There is a significant association between CTS and migraine headache. This association suggests the possibility of a common risk factors for development of migraine headache include older age, female gender, obesity, low functional and high symptoms scores and depressive symptoms.

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Section: Discussionsupporting

confidence: 93%

Are Carpal Tunnel Syndrome and Migraine Related?

Esmael

Gomaa

Hazem

2019

INDJ

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“…For example, Buchberger, et al [ 9 ] first described four features in sonographic images in CTS patients: (1) an increased cross-sectional area (CSA) of the MN at the level of the pisiform and hamate bone, (2) an increased swelling ratio (ratio of the CSA of the MN at the pisiform level to the distal radius level), (3) an increased flattening ratio, defined as the ratio of the length of the long to short axis of the MN, and (4) significant palmar bowing of the flexor retinaculum. Elsaman, et al [ 10 ] introduced a diagnostic criterion for CTS—the depth of the carpal tunnel (DCT), which is defined by the distance from the surface of the flexor retinaculum to the highest point of the capitate bone. To accommodate individual anthropometric variability, the wrist:forearm ratio (WFR), wrist–forearm difference (WFD), median-to-ulnar nerve ratio (MUR) and median-to-ulnar nerve difference (MUD) were also suggested as diagnostic criteria for CTS [ 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographical Evaluation of the Median Nerve Mobility in Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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Diagnostic ultrasound is widely used for evaluating carpal tunnel syndrome (CTS), an entrapment neuropathy of the median nerve (MN). Decreased mobility of the MN inside the carpal tunnel has been reported in CTS, and various methods have been used to evaluate MN mobility; however, there is still no conclusive understanding of its connection with CTS. The purpose of this study is to conduct a systematic review and meta-analysis of the current published literature on ultrasonographic evaluations of transverse and longitudinal MN displacement and to identify the relationship between MN mobility and CTS. This study was conducted in accordance with the 2020 PRISMA statement and the Cochrane Collaboration Handbook. Comparative studies that investigated differences in MN displacement between CTS patients and healthy controls were retrieved by searching the Cochrane Library, Embase and PubMed. A total of 15 case–control studies were included. Nine of 12 studies evaluating transverse MN displacement and 4 of 5 studies evaluating longitudinal MN gliding showed that the MN was less mobile in CTS patients than in healthy subjects. Despite the large heterogeneity among the 15 included studies, this systematic review and meta-analysis provide evidence that the mobility of the MN is significantly reduced in both transverse and longitudinal planes in CTS patients compared to healthy controls. Five of the 15 included studies reported that a decrease in transverse or longitudinal MN displacement in CTS was correlated with clinical symptoms or with severity as measured by a nerve conduction study (NCS).

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“…Knowledge of the tunnel's depth is crucial for surgical planning, as it may indicate the required approach for carpal tunnel release, particularly when performing endoscopic carpal tunnel release. Elsaman et al(24) used ultrasonography to measure the depth of the tunnel in the distal aspect in healthy controls and found it to be 7.91 mm. Corey et al…”

mentioning

confidence: 99%

Three-Dimensional Silicon Mold Analysis of the Carpal Tunnel: A Morphometric Study in Human Cadavers

Dsouza,

Bhat,

Kalthur

et al. 2023

Muscle Ligaments and Tendons J

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Purpose. Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an incidence rate of 6%. The significance of carpal tunnel shape and dimensions in idiopathic carpal tunnel syndrome has long been debated. Recent studies have examined the accuracy of previous morphometric studies, as the reported dimensions have conflicting results. The purpose of this study was to use cadavers to determine the dimensions and shape of the carpal tunnel using a three-dimensional digitization approach. Methods. The carpal tunnels of 35 cadavers were evacuated, and 210 silicon molds were created from 70 hands by inserting them into the soft tissue-carpeted tunnel. The mold was then scanned by a Structured Light Scanner from Steinbichler 3D scanner to obtain a three-dimensional image of the carpal tunnel, from which various carpal tunnel measures were calculated. Results. The width, height, and cross-sectional area (CSA) of the carpal tunnel decreased significantly from proximal to distal, with a narrow CSA at the distal end. Furthermore, the ulnar side of the tunnel was observed to be significantly deeper than the radial side. Conclusions. In this study our measured dimensions render a truncated elliptical coneshaped carpal tunnel tapering distally. Based on our analysis, the CSA of the distal carpal tunnel may be estimated by knowledge of the proximal tunnel CSA by using the formula (Distal CSA = 22.137 + 0.734 (Proximal CSA ). Knowledge of the tunnel's structural architecture is important in determining the aetiology of carpal tunnel syndrome associated with variant anatomy.

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Idiopathic Carpal Tunnel Syndrome: Evaluation of the Depth of the Carpal Tunnel by Ultrasonography

Cited by 5 publications

References 38 publications

Are Carpal Tunnel Syndrome and Migraine Related?

Are Carpal Tunnel Syndrome and Migraine Related?

Ultrasonographical Evaluation of the Median Nerve Mobility in Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis

Three-Dimensional Silicon Mold Analysis of the Carpal Tunnel: A Morphometric Study in Human Cadavers

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