Carpal tunnel syndrome (CTS) is neuropathy that occurs due to compression of the median nerve in the carpal tunnel. Acromegaly is one of the important causes of CTS. The aim of this study was to examine median nerve with ultrasound in acromegalic patients and to assess the relationship with activity, duration of disease and body composition parameters. We prospectively examined the cross-sectional area (CSA) of the median nerve with high-resolution ultrasound in 107 acromegalic patients – control group (70 females and 37 males) and 107 healthy controls (70 females and 37 males) matched for age, gender, and BMI. Body composition parameters were assessed by dual-energy X-ray absorptiometry (DXA). The Student t-tests and Pearson correlation were used for data analysis. The cross sectional area of the median nerve was increased in acromegalic patients compared to controls (11.9±4.8 mm2 vs. 7.7±2.4 mm2, P<0.001). Positive correlation was found between IGF-1 levels and CSA in the acromegalic group (R = 0.400, P<0.001). Relationship between CSA and duration of acromegaly was not confirmed. In acromegalic patients, BMI correlated with the CSA (R=0.294, P=0.002). There was no significant difference in BMI, fat mass between the acromegalic and control group, but lean mass was higher in acromegalic patients compared with controls (54.8±13.3 vs. 51±11.6, P=0.047). Lean mass and LMI (total body lean mass/height) positively correlated with CSA in acromegalic patients (R=0.340, P<0.001; R=0.424, P<0.001). No correlation was observed between fat mass and CSA of median nerve in all groups. We confirmed the enlargement of the median nerve in acromegalic patients. This enlargement is proportional to the degree of IGF-1 levels and is not dependent on the duration of the disease. The enlargement of the median nerve in acromegalic patients also depends on lean body mass and is not dependent on fat body mass.

Background: The purpose of this study was to assess changes in the cross-sectional area (CSA) of nervus medianus by ultrasound in newly diagnosed primary hypothyroid patients after thyroxine replacement treatment. Patients and methods:The cohort comprised 30 patients with newly diagnosed primary autoimmune hypothyroidism. These were subsequently compared with 30 controls, matched for sex, BMI and age. Ultrasound evaluation, including measurement of CSA at the level of the pisiform bone or tunnel inlet was performed at baseline and after 3 months. A CSA threshold of more than 10 mm 2 was considered pathological.

Background A bilateral carpal tunnel syndrome (CTS) is relatively commonly connected to hypothyroidism and presents in 5 to 10% of hypothyroid patients. Ultrasound imaging is a method of choice in early recognition of dynamic changes of median nerve in subclinical stages of CTS. Objectives Monitoring of ultrasound detectable changes of median nerve in transverse section level of carpal tunnel in patients with autoimmune hypothyroidisms. Methods A cross sectional comparative study on patients with autoimunne hypothyroidism, where transverse section breadth of median nerve in its entrance to carpal tunnel (Cross Sectional Area, CSA) was measured. CSA values over 0,098cm2 were considered abnormal according to American Journal of Roentgenology. Values were compared with the control group of healthy subjects based on gender and BMI. Difference between groups were statistically evaluated by unpaired T-test. Results Totally of 38 patients (mean age 64,68 yrs, 10 males/28 females, mean BMI 25,37 kg/m2, mean TSH 6,23 mU/l, fT4 15,28 pmol/l) were included in the study. The control group consists of 24 subjects (mean age 48,54 yrs, 13 males/11 females, BMI 25,00 kg/m2, mean TSH 1,54 mU/l, mean fT4 15,58 pmol/l). CSA was significantly higher in patients (mean 0.088 cm2) in comparison with controls (mean 0.071 cm2, p=0,002). In 3 hypothyroid patients pathological increase of CSA (mean 0,1 3cm2,7.8%) were presenting symptomatology. Conclusions Ultrasound findings have documented occurrence of subclinical and clinical CTS in patients with primary hypothyroidism. If CTS occurs, the thyroidal status should be evaluated to exclude possible hypothyroidism. Ultrasound examination of CSA enables the treatment effect monitoring in soft tissue structures in carpal tunnel area and it is an appropriate method for a long term evaluation of hypothyroid patients with this complication. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3319

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