The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study

Marschall, Alexander; Ficjian, A.; Stradner, Martin; Husic, Rusmir; Zauner, Dorothea; Seel, Werner; Simmet, Nicole E.; Klammer, Alexander; Heizer, Petra; Brickmann, Kerstin; Gretler, Judith; Fürst-Moazedi, Florentine; Thonhofer, Renè; Hermann, Josef; Graninger, Winfried; Quasthoff, Stefan; Dejaco, Christian

doi:10.1371/journal.pone.0162288

Cited by 12 publications

(32 citation statements)

References 28 publications

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“…Mondelli et al [33] showed that smaller initial CSA was predictive of better surgical outcomes. In contrast, some studies have shown that CSA was not predictive of outcomes after conservative management [34] or surgery [35]. Although our results showed smaller CSA in the good outcome group at 6 months post-injection, the difference between the groups was not significant.…”

Section: Discussioncontrasting

confidence: 99%

Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study

Ho¹,

Chen²,

Tsung-Ying³

et al. 2021

Int. J. Med. Sci.

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Background: Perineural injection therapy with 5% dextrose water (D5W) is a potential and innovative treatment with long-term efficacy for carpal tunnel syndrome (CTS). However, the prognostic factors of this management are lacking; hence, the aim of this retrospective study was to identify the prognostic factors of D5W perineural injection therapy for mild-to-moderate CTS. Methods: A total of 52 patients (52 wrists) diagnosed with mild-to-moderate CTS and treated with a single ultrasound-guided 5cc D5W perineural injection were retrospectively reviewed. Patient-reported injection outcomes (visual analog scale, VAS) at 6 months post-injection were categorized into two groups; (1) Good outcome, when symptom relief ≥50% compared to pre-injection and (2) Poor outcome, when symptom relief < 50% compared to pre-injection. Significant variables between groups were entered into a binary logistic regression with forward stepwise regression to determine the prognostic factors for these outcomes. Results: The treatment outcome was significantly related to body height and sensory nerve conduction velocity (SNCV) (159.1 ± 1.0 vs. 155.0 ± 1.8, p=0.04; 33.6 ± 0.8 vs. 28.3 ± 1.2, p=0.001, good vs. poor outcomes). However, only SNCV remained significantly correlated with the outcomes after conducting stepwise logistic regression (ORs: 1.201; 95% CI 1.05-1.38; p=0.01). Conclusions: SNCV was found to be a significant prognostic factor of treatment outcome for patients with mild-to-moderate CTS 6 months after a D5W perineural injection.

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Section: Discussioncontrasting

confidence: 99%

Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study

Ho¹,

Chen²,

Tsung-Ying³

et al. 2021

Int. J. Med. Sci.

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“…Even though the current limited evidences were contradictory to ours, questioning the prognostic value of ultrasound in long-term clinical outcomes after conservative management. [22] However, the sample size in their studies was small, with no explanation for the lack of association. In spite of this, the long-term clinical efficacy after local steroid injection has been reported in a previous 2-year follow-up study.…”

Section: Discussionmentioning

confidence: 98%

“…A recent study even questioned about the predictability of ultrasound in long-term recovery after conservative management. [22] It seemed the association between baseline ultrasound variables and long-term recovery remained ambiguous.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of ultrasonography in predicting therapeutic outcome for carpal tunnel syndrome after conservative treatment: A retrospective long-term follow-up study

et al. 2019

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Purpose:This study aimed at investigating prognostic values of different ultrasound variables in predicting therapeutic outcome of the patients with carpal tunnel syndrome (CTS) after conservative treatment in a long-term follow-up data.Materials and Methods:One hundred and three participants with 162 affected hands were enrolled in this retrospective study. Records of baseline clinical information, nerve conduction studies (NCSs), and ultrasound assessment were retrieved. A structured telephone interview was conducted for acquiring patients’ response to recovery after treatment. Multinomial logistic regression analysis was used to estimate the odds ratio and 95% confidence interval of individual ultrasound variable, adjusted for age, gender, and other confounding factors.Results:Perimeter at wrist (W-P), ratio of cross-sectional area of wrist over one-third distal forearm (R-CSA), changes of CSA from wrist to the one-third distal forearm (△CSA), and changes of perimeter from wrist to one-third distal forearm (△P) were negatively and significantly associated with “improved” and “no change” categories relative to reference category (“deteriorated” category). After adjustment for age, gender, affected hand side, surgical history, and comorbidity, for one unit increase of W-P/△CSA/△P, the odds of “improved” category versus “deteriorated” category decreased by 89.1%/56%/95.2%, whereas the odds of “no change” relative to “deteriorated” category decreased by 77.8%/54.6%/84.9% should one unit increase in the correspondent individual ultrasound variable.Conclusion:Ultrasound variables can significantly predict therapeutic outcome in CTS after conservative management in a long-term follow-up. Further studies may be required to assess whether a combination of clinical, NCS, and ultrasound variables can better predict the therapeutic outcome.

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“…All studies were of a descriptive nature, most were based on crosssectional designs, although several had a prospective design. 12,13 In most cases, the upper limb was the object the study (33 articles) when compared with the lower limb (6 articles). This is mainly due to the fact that the CSA has been extensively studied.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

“…Most studies used electro diagnostic tests as the gold standard for the diagnostic confirmation of a peripheral neuropathy (after the diagnosis based on a clinical exam). 6,8,9,12,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] Other studies used nuclear magnetic resonance (NMR) as the main diagnostic tool 28 or as a complementary tool, 5 which also occurred with surgical validation of findings. 4…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

Pathological Sonographic Values in Peripheral Nerve Entrapments—A Literature Review

Gázquez¹,

Bellosta-López

2019

Revista Fisioterapia Invasiva / Journal of Invasive Techniques

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Introduction In recent years, musculoskeletal ultrasound has become an important tool for the assessment of peripheral nerve entrapments in human subjects. Objective To research sonographic pathological values of peripheral nerve entrapments and to verify the usefulness of ultrasound for the assessment of the same. Material and Methods A literature search was conducted on the EBSCOHost platform between January 2016 and September 2017. Results Fifty-four articles were included in this review. Ultrasound showed good diagnostic values for the ulnar tunnel syndrome at the level of the tunnel (sensitivity 72–99%; specificity 53–100%) and at the level of the medial epicondyle (sensitivity 72–92%; specificity 75–93%). Conclusions Sonographic assessments may be considered a valid tool for the assessment of the peripheral nervous system. High diagnostic precision exists for the cross-sectional area in carpal tunnel syndrome and ulnar tunnel syndrome. There is a lack of evidence regarding the diagnosis of other neuropathies.

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The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study

Cited by 12 publications

References 28 publications

Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study

Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study

Prognostic value of ultrasonography in predicting therapeutic outcome for carpal tunnel syndrome after conservative treatment: A retrospective long-term follow-up study

Pathological Sonographic Values in Peripheral Nerve Entrapments—A Literature Review

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