Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

Abstract

Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aimed to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. In this study, 22 DM and 22 non-DM subjects with no symptoms or manipulations in non-dominant hands and wrists were assessed. Ultrasound evaluations of the length, width, cross-sectional area, and circumference of the fourth flexor tendon and the median nerve were performed in the two groups. There was no statistically significant difference in age (P value= 0.473), gender (P value= 0.364), or wrist circumference (P value= 0.1921) between the groups. This study showed no significant difference between the two groups in median nerve length (P value= 0.35), width (P value= 0.17), cross-sectional circumference (P value= 0.23), or cross-sectional area (P value= 0.16). Also, a comparison of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in length (P value = 0.68), width (P value= 0.80), cross-sectional circumference (P value= 0.70), or cross-sectional area (P value= 0.80). In conclusion, data from the present study showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not differ significantly with those of non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.