Is carpal tunnel syndrome in the elderly a separate entity? Evidence from median nerve ultrasound

Gregoris, Nattanit; Bland, Jeremy D.P.

doi:10.1002/mus.26618

Cited by 11 publications

(7 citation statements)

References 9 publications

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“…In this study, nerve stiffness was increased in older CTS patients. Some authors have speculated recently that CTS in the elderly may be a separate entity 23,24 . Median nerve CSA may be a less sensitive indicator for CTS in older patients as older CTS patients tend to have smaller CSA.…”

Section: Discussionmentioning

confidence: 99%

Shearwave Elastography in the Differentiation of Carpal Tunnel Syndrome Severity

Wee

Simon

2020

PM&R

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Background There is emerging evidence that ultrasound elastography may provide additional diagnostic information in peripheral neuropathies. Objective To investigate the use of ultrasound elastography to evaluate median nerve stiffness in patients with carpal tunnel syndrome (CTS), as well as the relationship between the elastographic stiffness and electrophysiological severity. Design Case control study. Setting Tertiary hospital outpatient neurophysiology clinic. Participants Twenty eight patients (47 wrists) with CTS and 25 control patients (25 wrists). Interventions None. Main Outcome Meaures Ultrasound parameters (median nerve cross‐sectional area [CSA] at carpal tunnel, ratio of median nerve CSA at carpal tunnel and forearm), shearwave elastography parameter (median nerve stiffness), and electrophysiological severity of carpal tunnel syndrome. Results In patients with CTS, median nerve stiffness by ultrasound elastography was increased between the different severity groups (control 83.5 ± 24.8, EDx negative CTS 84.2 ± 46.4, mild 117.7 ± 79.3, moderate 144.0 ± 71.1, severe 196.6 ± 48.4). The control versus moderate and severe subgroup was statistically significant. Conclusions In total, this study has demonstrated that ultrasound elastography was able to discriminate the severity of CTS whereas conventional ultrasound parameters did not.

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Section: Discussionmentioning

confidence: 99%

Shearwave Elastography in the Differentiation of Carpal Tunnel Syndrome Severity

Wee

Simon

2020

PM&R

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“…Another factor influencing the results might be the patients' age. In very recent studies, it has been demonstrated that the diagnostic accuracy of HRUS in grading CTS is reduced [17][18][19] in older patients. Unfortunately, age was not controlled in our study.…”

Section: Discussionmentioning

confidence: 99%

The Neurophysiological Severity of Carpal Tunnel Syndrome Cannot Be Predicted by Median Nerve Cross-Sectional Area and Wrist-to-Forearm Ratio

Martikkala

Himanen

Virtanen

et al. 2020

Journal of Clinical Neurophysiology

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Purpose: The median nerve cross-sectional area at the wrist (CSA) and the wrist-to-forearm ratio of the cross-sectional areas (WFR) are ultrasound parameters used in the diagnosis and grading of carpal tunnel syndrome. This study aimed to determine the diagnostic accuracy of the CSA and WFR as well as to compare their diagnostic value.Methods: A retrospective evaluation was conducted of a cohort of 218 patients who had undergone nerve conduction studies (NCSs) and an ultrasound of the median nerve. The examined wrists were classified into an NCS negative and three NCS positive (mild, moderate, and severe) categories. The CSA and WFR were compared across the categories. Results:The CSA and WFR were significantly smaller in the NCS negative category than in the NCS positive categories. The WFR was significantly smaller in the mild category than in the moderate category. The CSA could not be used to differentiate across the NCS positive categories. Conclusions:The CSA and WFR are satisfactorily reliable in detecting carpal tunnel syndrome, but they cannot be considered as surrogate indicators of electrophysiological severity.

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“…Recently, patient age has been shown to have an effect on the diagnostic accuracy of HRUS in determining the diagnosis and categorizing of the severity of CTS ( Moschovos et al, 2019 , Gregoris and Bland, 2019 ). In this present study, a slight negative correlation between patient age and wCSA was found, which is in line with the previous literature ( Moschovos et al, 2019 , Gregoris and Bland, 2019 ). However, fCSA did not show a similar correlation, indicating that age does not affect fCSA, at least in patients with moderate to extremely severe CTS.…”

Section: Discussionmentioning

confidence: 99%

Reduction in median nerve cross-sectional area at the forearm correlates with axon loss in carpal tunnel syndrome

Martikkala

Mäkelä

Himanen

2021

Clinical Neurophysiology Practice

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Is carpal tunnel syndrome in the elderly a separate entity? Evidence from median nerve ultrasound

Abstract: http://onlinelibrary.wiley.com/doi/10.1002/mus.26496/full.

Cited by 11 publications

References 9 publications

Shearwave Elastography in the Differentiation of Carpal Tunnel Syndrome Severity

Shearwave Elastography in the Differentiation of Carpal Tunnel Syndrome Severity

The Neurophysiological Severity of Carpal Tunnel Syndrome Cannot Be Predicted by Median Nerve Cross-Sectional Area and Wrist-to-Forearm Ratio

Reduction in median nerve cross-sectional area at the forearm correlates with axon loss in carpal tunnel syndrome

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