Ultrasound findings of carpal tunnel syndrome in a hunter syndrome patient

Abstract

This case demonstrated unique ultrasound findings in a Hunter syndrome with CTS. Ultrasound also localized the median nerve lesion in the setting of end-stage median neuropathy and nonlocalizing electrophysiology.

Ultrasound findings of carpal tunnel syndrome in a hunter syndrome patient

“…8 However, despite absent clinical and neurophysiological differences, vanVeen et al found a significant reduction of the ulnar nerve swelling in the treatment, but not in the placebo group. 1 Treatment, therefore, reduced ulnar nerve edema and inflammation as intended, but it had no effect on clinical symptoms or nerve conduction findings. The study, therefore, clearly shows that in focal neuropathies local corticosteroid injections do not exert their therapeutic effect directly on the peripheral nerve, but probably mainly on surrounding tissues.…”

“…We read with great interest the study by Alkhachroum and Preston about ultrasonographic (US) findings of carpal tunnel syndrome (CTS) in the case of a 40-yearold patient affected by mucopolysaccharidosis II. 1 The patient was evaluated by clinical, neurophysiological, and US examinations. He presented with pain and electric shocks in the fingers since childhood, with worsening during the preceding year.…”

“…In a recent report, vanVeen et al 1 randomized 63 patients with ulnar neuropathy at the elbow (UNE) into a treatment group (26 patients) who received corticoste-roid (combined with local anesthetic) injection and a placebo group (23 patients) who received saline injection near the ulnar nerve swelling. On follow-up 3 months later, similar improvement in UNE symptoms was observed in both groups.…”

Ultrasonographic evaluation of the median nerve at the level of the carpal tunnel outlet and mid forearm in patients with type II Mucopolysaccharidosis

“…There is a case report of an adult MPS II patient with end-stage CTS published by Alkhachroum et al which reveals the same US findings and acknowledges the role of US in identifying the median nerve and its alterations associated with CTS in MPS II patients. [29] A meta-analysis found that the sensitivity and specificity of US in establishing the CTS diagnosis in adults, is 77.6% and 86.8 %, respectively [30].…”

Neuromuscular ultrasound as the sole diagnostic test for carpal tunnel syndrome in Hunter syndrome

“…Alternatively, neuromuscular ultrasound is well-tolerated and can accurately diagnose CTS, while also providing anatomic visualization to guide management strategies. 8,9 Studies have investigated ultrasound for CTS detection in mucopolysaccharidoses, 6,10,11 but none examined the exclusive use of ultrasound to confirm diagnosis. We present a patient with Hunter syndrome in whom ultrasound alone confirmed CTS and revealed a profound median mononeuropathy.…”