Pathophysiology of Carpal Tunnel Syndrome

Duncan, Scott F. M.; Bhate, Oam; Mustaly, Hatim M.

doi:10.1007/978-3-319-57010-5_3

Cited by 55 publications

(23 citation statements)

References 100 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early diagnosis is essential to alleviate permanent nerve damage and functional disability. The diagnosis of CTS is usually based on clinical and neurophysiological studies [9].…”

Section: Discussionmentioning

confidence: 99%

“…The measurement of cross-sectional area (CSA) of the median nerve at the wrist is the most widely used ultrasonography method in CTS diagnosis [9]. Grading the severity of CTS is important for treatment planning and follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…Grading the severity of CTS is important for treatment planning and follow-up. Many researchers have classified CTS severity based on the clinical features and electrophysiological findings [9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Role of High Resolution Ultrasound in Assessment of Abnormalities of Median Nerve in Carpal Tunnel Syndrome

Agag¹,

Elsharkawy²,

Ahmed³

2020

OJMI

View full text Add to dashboard Cite

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and consists of the compression of the median nerve as it courses through the carpal tunnel. Carpal tunnel syndrome was diagnosed by history and physical examination, electrodiagnostic studies (EDX) were used to confirm the diagnosis. However, these studies are painful for most of the patients with high incidence of false positive or false negative results. Ultrasound is a low cost, short time and non-invasiveness technique that could be used to assess a number of parameters of the median nerve (MN) in cases of CTS. Objective: To assess the utility of high resolution ultrasound (HRUS) in assessment of median nerve in carpal tunnel syndrome through different ultrasound diagnostic criteria in patients with clinical and electrodiagnostic evidence of CTS. Patients and Methods: This study included a total of 60 participants divided into 2 groups; group A, the patients group included 30 patients with a clinical diagnosis of carpal tunnel syndrome (CTS) and group B, the control group who included 30 sex and age-matched healthy individuals. All the included cases were subjected to full history taking, full general and general examination. Nerve conduction studies were performed using a Caldwell Sierra Wave and the NCS consisted of sensory median nerve conduction tests using standard techniques. High resolution US was performed by using an Aplio 400 Ultrasound System. The following measurement was recorded in each of the included subjects including cross sectional area (CSA) of the median nerve, flattening ratio (FR) of median nerve and palmar bowing (PB) of the flexor retinaculum. Results: There was high statistically significant difference in the mean CSA and mean PB between the cases with CTS and healthy control. No statistically significant difference in the mean FR between the cases with CTS and healthy control.

show abstract

“…Early diagnosis is essential to alleviate permanent nerve damage and functional disability. The diagnosis of CTS is usually based on clinical and neurophysiological studies [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Role of High Resolution Ultrasound in Assessment of Abnormalities of Median Nerve in Carpal Tunnel Syndrome

Agag¹,

Elsharkawy²,

Ahmed³

2020

OJMI

View full text Add to dashboard Cite

show abstract

“…Increased pressure in the carpal tunnel can cause damage to blood vessels in the median nerve area, through the accumulation of proteins and inflammatory cells. Patients with vascular diseases such as Diabetes Mellitus, Peripheral Artery Disease cause circulatory disorders in the median nerve area, which can cause hypoxia and inflammation in the area (1).…”

Section: Microvascular Injurymentioning

confidence: 99%

“…Carpal Tunnel Syndrome, a common condition caused by compression of the median nerve in the carpal tunnel (1). In general, patients with this condition will experience symptoms of pain and paresthesia in the distribution of the median nerve, which includes the thumb, index finger, middle finger, and half of the ring finger (2).…”

Section: Introductionmentioning

confidence: 99%

Carpal Tunnel Syndrome (Diagnosis and Management)

Annisa

Rianawati

Rahayu

et al. 2021

JPHV

View full text Add to dashboard Cite

Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abnormal function of the median nerve based on nerve conduction studies. Conservative therapy is an option. Especially in Carpal Tunnel Syndrome patients with mild to moderate symptoms. Conservative therapy can be given in the form of corticosteroid and physical therapy. Patients with severe CTS or whose symptoms have not improved after four to six months of conservative therapy should be considered for surgical treatment.

show abstract

Work‐relatedness of carpal tunnel syndrome: Systematic review including meta‐analysis and GRADE

Hassan¹,

Beumer

Kuijer

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

Background and Aims Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome with a high prevalence among workers. Insights on the physical work‐related risk factors is necessary to develop appropriate preventative methods. The objective of this systematic review, including meta‐analyses, is to assess which physical work‐related risk factors are associated with carpal tunnel syndrome. Methods Systematic literature searches were carried out using PubMed and Embase until September 6, 2021. Studies were included if: (1) CTS was clinically assessed, (2) the studies were prospective cohort studies, and (3) the exposure was reported using terms of exposed/less or nonexposed. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results In total, 9270 patients with CTS from a population of 1,051,707 workers were included from 17 studies. Meta‐analyses revealed high‐quality evidence for associations between CTS and high exposures to repetition (hazard ratio [HR] 1.87, 95% CI 1.42–2.46), force intensity (HR 1.84, 95%CI 1.22–2.79), exposures above hand activity level of ACGIH (HR 1.75, 95%CI 1.40–2.17), and the Strain Index >10 (HR 1.58, 95% CI 1.09–2.30). No significant associations were found for pinch gripping, hand‐arm vibration or force duration. High computer‐use exposure was significantly associated with a decreased rate of work‐related CTS (HR 0.28, 95% CI 0.12–0.64). Conclusion This systematic review of prospective cohort studies found high certainty for an increased rate of CTS due to a high Strain Index, exposures exceeding the Activity Level of ACGIH, and high force intensity and high repetition. Workers performing tasks requiring both high force and high repetition even have a higher rate of developing CTS.

show abstract

Pathophysiology of Carpal Tunnel Syndrome

Cited by 55 publications

References 100 publications

Role of High Resolution Ultrasound in Assessment of Abnormalities of Median Nerve in Carpal Tunnel Syndrome

Role of High Resolution Ultrasound in Assessment of Abnormalities of Median Nerve in Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (Diagnosis and Management)

Work‐relatedness of carpal tunnel syndrome: Systematic review including meta‐analysis and GRADE

Contact Info

Product

Resources

About