The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

Lee, Soo-Ho; Cho, Hyung Rae; Yoo, Jun Sung; Kim, Young Uk

doi:10.3344/kjp.2020.33.1.54

Cited by 12 publications

(15 citation statements)

References 27 publications

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“…A diagnosis is typically made based on the physical examination and case history, even though in a few cases magnetic resonance imaging (MRI) might be indicated to rule out another disease in the location [ 5 , 6 ]. An important positive sign on physical examination is local tenderness superior to the joint line and lateral knee inferior to the epicondyle.…”

Section: Introductionmentioning

confidence: 99%

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The role of the iliotibial band cross-sectional area as a morphological parameter of the iliotibial band friction syndrome: a retrospective pilot study

et al. 2021

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Background: Iliotibial band friction syndrome (ITBFS) is a common disorder of the lateral knee. Previous research has reported that the iliotibial band (ITB) thickness (ITBT) is correlated with ITBFS, and ITBT has been considered to be a key morphologic parameter of ITBFS. However, the thickness is different from inflammatory hypertrophy. Thus, we made the ITB cross-sectional area (ITBCSA) a new morphological parameter to assess ITBFS. Methods: Forty-three patients with ITBFS group and from 43 normal group who underwent T1W magnetic resonance imaging were enrolled. The ITBCSA was measured as the cross-sectional area of the ITB that was most hypertrophied in the magnetic resonance axial images. The ITBT was measured as the thickest site of ITB. Results: The mean ITBCSA was 25.24 ± 6.59 mm 2 in the normal group and 38.75 ± 9.11 mm 2 in the ITBFS group. The mean ITBT was 1.94 ± 0.41 mm in the normal group and 2.62 ± 0.46 mm in the ITBFS group. Patients in ITBFS group had significantly higher ITBCSA (P < 0.001) and ITBT (P < 0.001) than the normal group. A receiver operator characteristic curve analysis demonstrated that the best cut-off value of the ITBT was 2.29 mm, with 76.7% sensitivity, 79.1% specificity, and area under the curve (AUC) 0.88. The optimal cut-off score of the ITBCSA was 30.66 mm 2 , with 79.1% sensitivity, 79.1% specificity, and AUC 0.87. Conclusions: ITBCSA is a new and sensitive morphological parameter for diagnosing ITBFS, and may even be more accurate than ITBT.

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Section: Introductionmentioning

confidence: 99%

“…Previous studies assessed the ITB thickness (ITBT) using a measurement at the approximate “halfway” point of the ITB [ 3 ]. However, an asymmetrical tear and partial thickening of the ITB can occur at any time [ 5 ]. Thus, measurement mistakes could occur routinely.…”

Section: Introductionmentioning

confidence: 99%

The role of the iliotibial band cross-sectional area as a morphological parameter of the iliotibial band friction syndrome: a retrospective pilot study

et al. 2021

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“…T1 weighted images provide excellent anatomical images at the location of tendon injury. [ 25 – 27 ] Our current results show that the AUC value of ROC for predicting PTTD was 0.95 with a sensitivity of 92.9% and a specificity of 90.0% in PTTCSA, and 0.92 with a sensitivity of 85.7% and a specificity of 85.0% in PTTT. These results suggest that the PTTCSA is a better predictor of PTTD than is the PTTT.…”

Section: Discussionmentioning

confidence: 55%

The predictive role of the posterior tibial tendon cross-sectional area in early diagnosing posterior tibial tendon dysfunction

et al. 2020

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A hypertrophied posterior tibial tendon (PTT) has been considered to be an important morphologic parameter of PTT dysfunction (PTTD). Previous research has demonstrated that the PTT thickness (PTTT) is correlated with early signs of PTTD. However, the thickness is different from hypertrophy. Thus, we devised the PTT cross-sectional area (PTTCSA) as a new predictive parameter for diagnosing the PTTD. The PTT data were acquired from 14 patients with PTTD and from 20 normal individuals who underwent ankle magnetic resonance imaging. We measured the PTTT and PTTCSA at the PTT on the ankle magnetic resonance imaging. The mean PTTT was 2.43 ± 0.39 mm in the normal group and 3.40 ± 0.42 mm in the PTTD group. The average PTTCSA was 16.10 ± 4.27 mm 2 in the normal group and 26.93 ± 4.38 mm 2 in the PTTD group. The receiver operator characteristic analysis curve demonstrated that the highest predictive value of the PTTT was 3.07 mm, with 85.7% sensitivity, 85.0% specificity. The highest predictive value of the PTTCSA was 22.54 mm 2 , with 92.9% sensitivity, 90.0% specificity. Our findings suggest that the PTTCSA was a more valid predictor of PTTD, even though the PTTT and PTTCSA were both significantly associated with PTTD.

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“…Second, erroneous measurements of the CFLCSA and CFLT may happen on A-MRI. Even though we were trying to analyze these morphologic measurement methods and view the CFL at the coronal image section clearly, inhomogeneity of the coronal section images was still possible due to discrepancies in the cutting level or angle in the A-MRI resulting from individual anatomic differences and technical problems (25). Third, despite there being several alternative imaging diagnostic tools for evaluating AI, such as US examination (26,27), arthroscopy, manual anterior drawer test, or stress radiography, our research protocol analyzed only the measurement of the CFLCSA and CFLT using A-MRI.…”

Section: Discussionmentioning

confidence: 99%

Prediction of suspicious ankle instability using the calcaneofibular ligament cross-sectional area

Park¹,

Han²,

Kim³

et al. 2021

Quant Imaging Med Surg

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Background: An injured calcaneofibular ligament (CFL) is a major cause of ankle instability (AI). Previous research has demonstrated that the thickness of the calcaneofibular ligament (CFLT) is correlated with higher-grade sprains and ankle instability. However, inflammatory hypertrophy is distinct from ligament thickness; accordingly, we considered that the calcaneofibular ligament cross-sectional area (CFLCSA) as a potential morphological parameter to analyze inflammatory CFL. We hypothesized that the CFLCSA was a key morphologic parameter in AI diagnosis. Methods:We gathered the CFL data of 26 AI patients and 25 control subjects who had undergone ankle magnetic resonance imaging (A-MRI), and it had revealed no evidence of AI. Ankle level T1-weighted coronal A-MRI images were acquired. Using our image analysis program (INFINITT PACS), we analyzed the CFLT and CFLCSA at the CFL on the A-MRI. The CFLCSA was measured as the whole ligament cross-sectional area of the CFL that was most hypertrophied in the transverse A-MR images. The CFLT was measured at the thickest level of CFL.Results: The mean CFLT was 3.49±0.82 mm in the control group, and 4.82±0.76 mm in the AI group.The mean CFLCSA was 33.31±7.02 mm 2 in the control group, and 65.33±20.91 mm 2 in the AI group.The AI patients had significantly greater CFLT (P<0.001) and CFLCSA (P<0.001) than the control group participants. A receiver operating characteristic (ROC) curve analysis in the evaluation of the diagnostic tests showed that the optimal cut-off score of the CFLT was 4.06 mm, with 76.9% sensitivity, 76.0% specificity, and an area under the curve (AUC) of 0.89 (95% CI, 0.79-0.99). The optimal cut-off threshold of the CFLCSA was 43.85 mm 2 , with 92.3% sensitivity, 92.0% specificity, and AUC of 0.94 (95% CI, 0.86-1.00).Conclusions: Even though the CFLT and CFLCSA were both significantly associated with AI, the CFLCSA was a more sensitive diagnostic test.

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The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

Cited by 12 publications

References 27 publications

The role of the iliotibial band cross-sectional area as a morphological parameter of the iliotibial band friction syndrome: a retrospective pilot study

The role of the iliotibial band cross-sectional area as a morphological parameter of the iliotibial band friction syndrome: a retrospective pilot study

The predictive role of the posterior tibial tendon cross-sectional area in early diagnosing posterior tibial tendon dysfunction

Prediction of suspicious ankle instability using the calcaneofibular ligament cross-sectional area

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