Article

OBJECTIVES: To provide a quantitative analysis of ultrasonographic measurements
and possible pathophysiology of carpal tunnel syndrome by comparing
cross-sectional areas of the median nerve, carpal tunnel, and nerve/tunnel index
and the difference in ultrasonographic findings between affected and nonaffected
hands and between sexes.
DESIGN: Blinded comparison study. SETTING: Secondary
referral and training hospital of institutional practice. PARTICIPANTS: Patients
(N=51; 42 women, 9 men) with suspected carpal tunnel syndrome who underwent
sonography within 1 week after the electrodiagnostic study. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Electrodiagnostic and ultrasonographic studies
were conducted on both upper extremities. Cross-sectional areas of the median
nerve and carpal tunnel were measured at 2 separate levels; proximal and distal
cross-sectional areas of the carpal tunnel were each measured at the
scaphoid-pisiform and trapezium-hamate levels, respectively. RESULTS: Comparison
between normative (n=24) and abnormal hands (n=78) revealed the following: the
mean proximal cross-sectional areas of the median nerve, carpal tunnel, and
nerve/tunnel index of electrodiagnostically normative hands were 10.941mm(2),
192.43mm(2), and 5.635%, respectively, whereas those of abnormal hands were
13.74mm(2), 208.87mm(2), and 6.693%, respectively, showing statistically
significant differences for all (P<.05). Distal measurements of the
cross-sectional area of the median nerve, carpal tunnel, and nerve/tunnel index
were 10.088mm(2), 150.4mm(2), and 6.762%, respectively, in normative hands, and
11.178mm(2), 149.6mm(2), and 7.493%, respectively, in abnormal hands, showing no
statistically significant differences (P>.05). In women, proximal cross-sectional
areas of the median nerve and nerve/tunnel index of abnormal hands showed
statistically significant differences, but no ultrasonographic measurement with a
statistically significant difference was observed in men. CONCLUSIONS: Compared
with nonaffected hands, the proximal cross-sectional areas of the median nerve
and carpal tunnel were greater, but the distal ultrasonographic measurements were
not in affected hands. Ultrasonographic findings of carpal tunnel syndrome were
different according to sex.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS