Ulnar Nerve Entrapment at the Elbow: Correlation of Magnetic Resonance Imaging, Clinical, Electrodiagnostic, and Intraoperative Findings

Britz, Gavin W.; Haynor, David R.; Kuntz, Charles; Goodkin, Robert; Gitter, Andrew; Maravilla, Kenneth R.; Kliot, Michel

doi:10.1227/00006123-199603000-00007

Cited by 63 publications

(77 citation statements)

References 16 publications

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“…Thirteen studies, with a total of 509 affected wrists in 373 patients with CTS, were left for final assessment (7,8,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). The number of referents was 407, 192 of whom were healthy volunteers (287 wrists in 9 of 13 studies), 42 of whom were the study patients (49 contralateral symptom-free wrists of patients in 2 of 13 studies), and 173 of whom were symptomatic referemce patients imaged for a wrist pathology other than CTS (173 wrists in 2 of 13 studies).…”

Section: Resultsmentioning

confidence: 99%

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Magnetic resonance imaging findings in respect to carpal tunnel syndrome

Pasternack¹,

Malmivaara²,

Tervahartiala³

et al. 2003

Scand J Work Environ Health

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The objective of this systematic review was to examine the technical and diagnostic capability of magnetic resonance imaging (MRI) to identify carpal tunnel syndrome (CTS). Two independent authors retrieved and screened the existing data and extracted the clinical and validity data adhering to predefined inclusion criteria. The MRI methods and findings were analyzed by two experienced radiologists. Disagreements were solved in consensus. The MRI findings of 373 affected wrists in 13 studies were compared with asymptomatic referents or a series of patients with non-CTS wrist pain. Increased T2-signal, cross-sectional area, and flattening of the median nerve inside the carpal tunnel, as well as bowing of the flexor retinaculum, were the most frequently occurring signs in CTS. Reliable assessment of the sensitivity and specificity of certain MRI signs in respect to CTS remained difficult due to study heterogeneity. There is an obvious need for imaging studies in which validated diagnostic criteria are used.

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Section: Resultsmentioning

confidence: 99%

“…Tinel's sign and Phalen's test are prone to false-positive and false-negative results (5). From 53% to 98% of patients with clinically diagnosed CTS have abnormalities in nerve conduction tests (7). Imaging techniques had minor importance in the assessment of CTS before the introduction of magnetic resonance imaging (MRI) (8).…”

mentioning

confidence: 99%

Magnetic resonance imaging findings in respect to carpal tunnel syndrome

Pasternack¹,

Malmivaara²,

Tervahartiala³

et al. 2003

Scand J Work Environ Health

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“…1,4,5,27,36) However, a significant number of patients with clinical problems must be followed up or treated in the postoperative period. Sonography is helpful either to confirm the decompressive surgery or to identify the problems in patients who fail to improve.…”

Section: Discussionmentioning

confidence: 99%

“…20) Magnetic resonance neurography may also be used and results are impressive. 4,10) However, magnetic resonance neurography studies are not cost-effective and may not be indicated as part of the routine assessment of patients with suspected CTS or for follow up of patients with unsatisfactory results. Sonography of the median nerve and measurement of the crosssectional area provides an alternative diagnostic modality for the evaluation of CTS.…”

Section: Discussionmentioning

confidence: 99%

Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Çolak

Kutlay

Pekkafalı

et al. 2007

Neurol. Med. Chir.(Tokyo)

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The diagnosis of carpal tunnel syndrome (CTS) is mainly based on the characteristic symptoms and confirmed with nerve conduction studies. Sonography can provide measurements of the increased cross-sectional area of median nerve. The use of sonography was evaluated for the diagnosis and postoperative follow up of 48 wrists in 26 consecutive patients with CTS. Clinical evaluation and sonography were effective for the diagnosis in 40 wrists. Nerve conduction studies were needed in eight wrists, because of the decrease in cross-sectional area of the nerve as a result of degenerative changes. After 3 months, sonography detected statistically significant decreases in the cross-sectional areas of the median nerves. The sonographic studies were well tolerated by all patients. Sonography was both time-saving and cost-effective.

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“…Median motor distal latency is considered to be prolonged if it is more than 4.4 msec at 7 cm and the syndrome is considered to be severe when the distal motor latency is more than 4.6 msec. The patients in our group has distal motor latencies of more than 4.6 msec which can be classified as severe carpal tunnel syndrome (2,3,17,20). The control group was composed of 21 female patients' dominant side wrists that had no complaints and examination findings of carpal tunnel syndrome.…”

Section: Methodsmentioning

confidence: 99%

Quantitative MRI analysis of idiopathic carpal tunnel syndrome

Oge¹,

Acu²,

Gucer³

et al. 2012

Turkish Neurosurgery

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ABSTRACTaIM: The aim of this study was to try to find parametric ratios for the diagnosis and pathophysiology of carpal tunnel syndrome using MR. MaterIaL and MetHOds:Dominant side wrist MRI examinations of 27 female carpal tunnel patients and 21 normal females were compared. The carpal tunnel contents area / carpal tunnel cross section area ratio was defined, analysed and discussed with the literature. resuLts: Carpal tunnel contents / wrist area ratios of the carpal tunnel patients were measured and compared with the control group. This comparison revealed that the proportion of the contents of the carpal tunnel is increased in the carpal tunnel syndrome patients. Palmar bowing was found to be increased and median nerve cross section area was found to be increased at the proximal entrance of the carpal tunnel.cOncLusIOn: As Phalen has postulated, the volume of the contents of the carpal tunnel were found to be increased in the carpal tunnel syndrome patients. Carpal tunnel cross section areas remained the same with the control group. This increase can be demonstrated by MRI imaging which can provide an evidence for the pathophysiology of carpal tunnel syndrome.keywOrds: Carpal tunnel syndrome, Area measurement, Ratio ÖZ aMaÇ: Bu çalışmanın amacı, el bileği MR incelemesiyle tespit edilen karpal tünel kapsamı/karpal tunel alanı oranları ile karpal tunel sendromuna diagnostik ve patofizyolojik bir yaklaşımda bulunmaktır. yÖnteM ve gereÇLer: 27 karpal tunel hastası kadın ile dominant el bileği MR incelemesi yapılan 21 kadından oluşan kontrol grubunun el bilek MR ları karşılaştırılmıştır. Karpal tunel kapsamı / karpal tunel alanı oranı tanımlanarak bu oran, median sinir alanı ve transverse karpal ligamentteki palmar yaylanma ölçülerek analiz edilmiştir.BuLguLar: Seride karpal tunel kapsamı/karpal tunel alanı oranında karpal tunel sendromlu hastalarda karpal tunel kapsamı lehinde istatistiksel olarak anlamlı bir artış tespit edilmiştir. Hastalarda karpal tunel proksimal girişinde ölçülen median sinir kesit alanlarında ve transvers karpal ligament palmar yaylanmasında da istatistiksel olarak anlamlı bir artış bulunmuştur. sOnuÇ: Karpal tunel sendromlu hastalarda Phalen'in öne sürdüğü gibi karpal tunel kapsamında kronik travmaya bağlı bir artış tespit edilmiştir. Bu kapsam artışına karşılık karpal tunel yüzey alanlarında anlamlı bir artış tespit edilmemiştir. Bu bulgu MR ile gösterilebilmektedir ve karpal tunel sendromunun fizyopatolojisinin anlaşılması konusunda bir kanıt olabilmektedir.anaHtar sÖZcÜkLer: Karpal tunel sendromu, Alan ölçümü, Oran

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Ulnar Nerve Entrapment at the Elbow: Correlation of Magnetic Resonance Imaging, Clinical, Electrodiagnostic, and Intraoperative Findings

Cited by 63 publications

References 16 publications

Magnetic resonance imaging findings in respect to carpal tunnel syndrome

Magnetic resonance imaging findings in respect to carpal tunnel syndrome

Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Quantitative MRI analysis of idiopathic carpal tunnel syndrome

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