Carpal tunnel: MR imaging. Part II. Carpal tunnel syndrome.

Abstract

The magnetic resonance (MR) images of 14 wrists of patients with carpal tunnel syndrome (CTS) were studied. Four general findings visible regardless of the cause of CTS included swelling of the median nerve, best evaluated at the level of the pisiform bone; flattening of the median nerve, most reliably judged at the hamate level; palmar bowing of the flexor retinaculum, best visualized at the level of the hamate bone; and increased signal intensity of the median nerve on T2-weighted images. Findings related to cause were tendon sheath edema in traumatic tenosynovitis, synovial hypertrophy in rheumatoid tenosynovitis, a ganglion cyst, and excessive amount of fat within the carpal tunnel, a persistent median artery, and a large adductor pollicis muscle. Knowledge of these findings may permit more rational choice of treatment. In four cases in which symptoms persisted after surgery, findings valuable in explaining or predicting the failure included incomplete incision of the flexor retinaculum, excessive fat within the carpal tunnel, persistent neuritis of the median nerve, and development of neuromas.

Magnetic resonance imaging findings in respect to carpal tunnel syndrome

“…Description of the comorbid conditions, hand loading activities, and invasive treatment prior to the magnetic resonance imaging (MRI) of the patients in the included studies and the total external valitity score of the studies. (NM = not mentioned, NCS = nerve conduction study, CTS = carpal tunnel syndrome) (22,23) arthritis that may have causto two-to threefold as it entered carpal tunnel (bilateral) ed CTS (clerk, typist, in the pisiform level indicated CTS the best barber), 3 had unusual upper-limb activity (painting, hammering, racket sports)…”

Carpal tunnel syndrome: diagnosis with high-resolution sonography.

“…Middleton et al [3] and Mesgarzadeh et al [4,5] resolution of the transducer, which, according to its manufacturer, is 0.2 mm for axial resolution and 0.5 mm for lateral resolution in the focal zone. In tissue, the effective spatial resolution depends on echo amplitude and tissue attenuation.…”

Quantitative MRI analysis of idiopathic carpal tunnel syndrome

“…After these four tendon groups, flexor digitorum profundus tendons are found in the deeper layer. Lumbrical muscles usually originate distally to the exit of the tunnel (10,12). The median nerve is placed under the flexor retinaculum in the proximal portion of the tunnel.…”