Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures

Abstract

ObjectiveTo study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales.MethodsWe performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and likelihood ratios were calculated separately by gender.ResultsWe consecutively enrolled 370 cases and 747 controls. The wrist-palm ratio, waist-hip-height ratio and waist-stature ratio showed the highest proportion of cases with abnormal values in the severe stages of CTS for clinical and electrophysiological severity scales in both genders. Accuracy tended to increase with CTS severity for females and males. In severe stage, most of the indexes presented moderate accuracy in both genders. Among subjects with severe CTS, the wrist-palm ratio presented the highest AUC for hand measures in the clinical and electrophysiological severity scales both in females (AUC 0.83 and 0.76, respectively) and males (AUC 0.91 and 0.82, respectively). Among subjects with severe CTS, the waist-stature ratio showed the highest AUC for body measures in the clinical and electrophysiological severity scales both in females (AUC 0.78 and 0.77, respectively) and males (AUC 0.84 and 0.76, respectively). The results of waist-hip-height ratio AUC were similar.ConclusionsWrist-palm ratio, waist-hip-height ratio and waist-stature ratio could contribute to support the diagnostic hypothesis of severe CTS that however has to be confirmed by nerve conduction study.

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

“…Moreover, in a study of carpal tunnel characteristics performed with magnetic resonance imaging, women turned out to have a smaller carpal tunnel area and a smaller free space in carpal tunnel ( Bower et al , 2006 ). Recent studies confirmed that certain hand/wrist anthropometric configurations are associated with increased risk and severity of CTS ( Mondelli et al ., 2014 , 2015 , 2016a , 2016 b). Among anthropometric factors, body mass index is a well-known determinant of CTS ( Shiri et al , 2015 ); it might also increase the detrimental effect of biomechanical exposures ( Burt et al , 2013 ; Shiri et al , 2015 ).…”

Reliability of ultrasound speckle tracking with singular value decomposition for quantifying displacement in the carpal tunnel

“…Although there is evidence that hand morphology is associated with CTS, it seems to be the ratio between wrist width and depth that differs most between controls and CTS patients (Farmer & Davis, 2008). So far, this seems to hold limited diagnostic and prognostic value (Mondelli et al, 2015).…”

Can the First Web Space Angle Be Predictive of Carpal Tunnel Syndrome?

“…Anthropometric evaluations are also methods that have been studied over the past years and the relationship between hand structural features and CTS (6,11,22–26). According to these studies, we can predict pathophysiological changes in the carpal tunnel in terms of slower capillary circulation, hypoxia of nerve fibres, oedema and increased pressure inside the carpal tunnel, and consequently reduced median nerve conductivity.…”

“…According to these studies, we can predict pathophysiological changes in the carpal tunnel in terms of slower capillary circulation, hypoxia of nerve fibres, oedema and increased pressure inside the carpal tunnel, and consequently reduced median nerve conductivity. In anthropometric studies conducted in literature; it has been investigated as to whether or not features such as hand length, wrist width and wrist ratio were related to CTS in relation to healthy controls, but the results were found to be contradictory(22–26). As a result, it has been reported that other personal factors such as hand use status and age, which facilitate compression, may also affect these factors.…”