Sonographic correlation between measures of the median nerve and electrophysiological severity in carpal tunnel syndrome

Bueno-Gracía, Elena; Tricás-Moreno, José Miguel; Fanlo-Mazas, Pablo; Malo-Urriés, Miguel; Haddad-Garay, María; Miguel, Elena Estébanez de; Hidalgo-García, César; Ruiz-de-Escudero-Zapico, Alazne; Polo, Santos Caudevilla

doi:10.1016/j.math.2016.10.016

Cited by 3 publications

(4 citation statements)

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“…The wrist-to-forearm ratio is another recommended measurement; however, the sensitivity and specificity of the CSA pisiform and wrist/forearm ratio are similar. 18 19 One study found that the wrist-to-forearm ratio was superior, 12 whereas Visser et al 20 stated that this ratio is not superior to CSA pisiform . Ulaşlı et al measured CSA at three levels of the carpal tunnel and suggested that a maximum CSA of >10 mm 2 is more sensitive for the US diagnosis of CTS.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Significance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies

2016

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Background and PurposeWe determined the reliability of ultrasonography (US) measurements for diagnosing carpal tunnel syndrome (CTS) and their correlation with symptom duration and electrophysiology findings. We determined whether the ratio of the median-to-ulnar cross-sectional areas (CSAs) can support CTS diagnoses.MethodsThe pisiform CSA (CSApisiform), swelling ratio (SR), palmar bowing, and CSApisiform/ulnar CSA (CSAulnar) measurements made in two subgroups of CTS patients (having sensory affection alone or having both sensory and motor affection) were compared with controls. CSAulnar was measured in Guyon's canal at the level of most-protuberant portion of the pisiform bone.ResultsThe values of all of the measured US parameters were higher in patients with CTS (n=50) than in controls (n=62). CSApisiform could be used to diagnose CTS of mild severity. All of the parameters were positively correlated with the distal latency of the compound muscle action potential, and all of them except for SR were negatively correlated with the sensory nerve conduction velocity. A CSApisiform/CSAulnar ratio of ≥1.79 had a sensitivity of 70% and a specificity of 76% for diagnosing CTS.ConclusionsOnly CSApisiform measurements were reliable for diagnosing early stages of CTS, and CSApisiform/CSAulnar had a lower diagnostic value for diagnosing CTS.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Significance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies

2016

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“…Ultrasound measurements of the median nerve, especially in the cross-sectional area of the median nerve in the wrist, could be used as complementary data to diagnose CTS and determine its severity in the clinical context [32]. The usefulness of sonography in monitoring CTS has been investigated by many authors [33,34].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

et al. 2019

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Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aimed to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. In this study, 22 DM and 22 non-DM subjects with no symptoms or manipulations in non-dominant hands and wrists were assessed. Ultrasound evaluations of the length, width, cross-sectional area, and circumference of the fourth flexor tendon and the median nerve were performed in the two groups. There was no statistically significant difference in age (P value= 0.473), gender (P value= 0.364), or wrist circumference (P value= 0.1921) between the groups. This study showed no significant difference between the two groups in median nerve length (P value= 0.35), width (P value= 0.17), cross-sectional circumference (P value= 0.23), or cross-sectional area (P value= 0.16). Also, a comparison of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in length (P value = 0.68), width (P value= 0.80), cross-sectional circumference (P value= 0.70), or cross-sectional area (P value= 0.80). In conclusion, data from the present study showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not differ significantly with those of non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.

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“…CSA greater than or equal to 9 mm 2 may indicate the presence of CTS [ 8 ]. Additionally, it has been found that median nerve CSA at the wrist correlated with electrophysiological severity in CTS patients [ 6 , 7 ]. In our study, although electrophysiological and morphological improvements were seen in the acupuncture group, the relationship between change of CSA and electrophysiological changes was not correlated.…”

Section: Discussionmentioning

confidence: 99%

“…US is an inexpensive and easily accessible imaging method and it can provide morphologic data of the median nerve in patients with CTS. Additionally, CSA of the median nerve was found to be associated with severity of CTS [ 6 , 7 ]. A cut-off value of 9 mm 2 for median nerve CSA at the wrist level was set with a high sensitivity (% 99) in CTS diagnosis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study

Ural

Öztürk

2017

Evidence-Based Complementary and Alternative Medicine

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Introduction The aim of this study was to explore the acupuncture effect on the cross-sectional area (CSA) of the median nerve at the wrist in patients with carpal tunnel syndrome (CTS) and, additionally, to identify whether clinical, electrophysiological, and ultrasonographic changes show any association. Methods Forty-five limbs of 27 female patients were randomly divided into two groups (acupuncture and control). All patients used night wrist splint. The patients in the acupuncture group received additional acupuncture therapy. Visual analog scale (VAS), Duruöz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were noted before and after the treatment in both groups. Results VAS, DHI, Quick DASH scores, and electrophysiological measurements were improved in both groups. The median nerve CSA significantly decreased in the acupuncture group, whereas there was no change in the control group. Conclusion After acupuncture therapy, the patients with CTS might have both clinical and morphological improvement.

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Sonographic correlation between measures of the median nerve and electrophysiological severity in carpal tunnel syndrome

Cited by 3 publications

References 0 publications

Diagnostic Significance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies

Diagnostic Significance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study

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