Recent Advances in Ultrasound Diagnosis of Carpal Tunnel Syndrome

Abstract

With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics can be observed with real-time imaging. In recent reports, it has been shown that ultrasonic examination can provide similar diagnostic accuracy as nerve conduction study in the diagnosis of carpal tunnel syndrome. It has been expected that ultrasound demand in daily medical care will continue to increase. Ultrasonography in carpal tunnel syndrome shows an enlarged median nerve in proximal carpal tunnel, thickening of the flexor retinaculum, and edema around flexor tendons in cross-sectional images. In addition, with the introduction of new technologies such as ultrasonic elastography and speckle tracking, it has become possible to quantify dynamics and material property changes of nerves, tendons, and their surrounding structures. In this review, we describe recent advancements of carpal tunnel syndrome diagnosis based on ultrasound dynamic images, and discuss its pathology.

Carpal Tunnel Syndrome in Transthyretin Cardiac Amyloidosis: Implications and Protocol for Diagnosis and Treatment

“…Accounting for approximately 90% of all nerve entrapment pathologies, CTS has a prevalence of 0.2% to 4% in the general population [ 4 , 14 ]. CTS has many etiologies, including pregnancy, rheumatoid arthritis, hypothyroidism, gout, acromegaly, diabetes mellitus, tumors, and in our case, amyloidosis [ 14 ].…”

“…CTS has a peak incidence at 40-60 years of age with females twice as likely to be affected than males [5,6]. CTS in the general population has been shown to have a prevalence ranging from 0.2% to 4%, which is drastically increased to 15% to 60% when observing patients with systemic amyloidosis [4,[7][8][9][10][11]. The temporal relationship between CTS and CA has also been examined, and it has been determined that CTS precedes cardiac manifestations by 5-10 years [1,2].…”

“…Presenting symptoms typically include numbness, paresthesias, and pain along the median nerve distribution. First reported in 1854, CTS is recognized as the most frequent peripheral neuropathy [ 4 ]. CTS has a peak incidence at 40-60 years of age with females twice as likely to be affected than males [ 5 , 6 ].…”

Effects of wrist extension on median nerve and flexor tendon excursions in patients with carpal tunnel syndrome: a case control study

“…However, to the best of our knowledge, longitudinal median nerve excursion inside carpal tunnel in finger flexion and extension motion has not been compared extensively in patients with CTS. Although Yoshii et al considered the speckle tracking method superior to the Doppler ultrasonographic method because of its potential usefulness for evaluating stress on the tendon and SSCT regardless of the angle between the object and the ultrasonographic transducer [ 23 ], duplex Doppler ultrasonographic method has the advantages of easily differentiating nerve and tendon gliding and defining the finger flexion and extension phases from the bidirectional Doppler waveforms. Therefore, we chose the duplex Doppler method to evaluate the gliding of the median nerve and flexor tendons in this study.…”

Effect of Perineural Injection with Different Dextrose Volumes on Median Nerve Size, Elasticity and Mobility in Hands with Carpal Tunnel Syndrome

“…The gold standard of diagnosis is electrophysiological study, but the ultrasonography was applied in recent decades for better approach to morphology change of median nerve. The cross-sectional area of median nerve became another diagnostic option for CTS [ 3 ]. In addition, dynamic ultrasound was also a useful tool to assess the flexor tendon and median nerve motion in response to finger and hand movement [ 4 , 5 ].…”