Correlation of High-Resolution Ultrasonographic Findings With the Clinical Symptoms and Electrodiagnostic Data in Carpal Tunnel Syndrome

Abstract

There are several different imaging methods that are helpful in the diagnosis of carpal tunnel syndrome, including traditional radiography, computed tomography (CT), and magnetic resonance imaging (MRI). CT and MRI offer the advantage of providing direct visualization of the structural abnormality of the carpal tunnel and median nerve, but both of these modalities are expensive and time-consuming. Recently, high-resolution ultrasonography has been reported to be effective in the study of the musculoskeletal system. The authors designed a case-control study to assess the diagnostic value of high-resolution ultrasonography. Forty-eight patients, for a total of 96 hands, whose diagnosis was confirmed by self-administered questionnaire and electrodiagnostic tests, underwent high-resolution ultrasonographic studies. The authors compared the sonographic findings with the electromyographic data and the patients' severity scores on the self-questionnaires. Proximal swelling of the median nerve at the entrance to the carpal tunnel was found to correlate with the nerve conduction data. Also, compression of the median nerve under the transverse carpal ligament was found to correlate with the subjective symptoms. Although ultrasonography is not an ideal method of diagnosis for carpal tunnel syndrome, it may be helpful for estimating the symptom severity and nerve conduction deficit.

Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study

“…Abicalaf et al 9 found an average decrease of 6.4 mm 2 (CI, 5.6 -7.2 mm 2 ) and Colak et al 10 reported an average decrease of 1.3 mm 2 (CI, 0.9 -1.6 mm 2 ). In contrast to the other studies, the work of Lee et al 11 reported a 2.0-mm 2 increase of the median nerve CSA (CI, 0.9 -3.0 mm 2 ). Our results lay between those reported by Abicalaf et al 9 and Lee et al 11 and are in accordance with those by Colak et al 10 Our CIs and those of the Colak et al 10 study do not overlap with the remaining 2, 9,11 indicating that results are not compatible.…”

Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity

“…In these instances imaging can play an important role in helping to define the site and etiology of nerve compression or in establishing an alternative diagnosis [2]. Hence, it has been widely reported that imaging modalities can feasibly demonstrate the causes and locations of NECS [1][2][3][4][5][6][7][8][9][10][11].…”

High‐resolution ultrasound analysis of subsynovial connective tissue in human cadaver carpal tunnel

“…8,[10][11][12] Ultrasound imaging has been described to detect pathologies such as thickening of the flexor tendons 13 and transverse carpal ligament, 14 shape and echogenicity alterations, restricted median nerve sliding in the carpal tunnel, 15,16 synovial proliferation, soft-tissue infection and joint effusion, tissue calcification and tumors, 17 persistent median artery, 18 tendinous and ligamentous injuries and swelling of the median nerve in the proximal part of the carpal tunnel, and flattening of the median nerve in the distal part of the carpal tunnel. 6,14,[19][20][21] High-resolution ultrasonography with approximately 7 MHz transducers is suitable for assessment of dynamic changes in the tunnel. Ultrasonography is comparable in image quality to magnetic resonance imaging (MRI) and computed tomography (CT).…”