Synovial histology in carpal tunnel syndrome

Fuchs, Peter; Nathan, Peter A.; Myers, Lee D.

doi:10.1016/0363-5023(91)90208-s

Cited by 117 publications

(67 citation statements)

References 12 publications

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“…Vascular sclerosis and edema were consistent findings, present in 98% and 85%, respectively, in one study [16,17]. This study also demonstrated that edema varies with the degree of carpal tunnel syndrome; increasing from mild to moderate disease and then decreasing with advanced disease.…”

Section: Idsupporting

confidence: 79%

“…Gender CTS Vol R(mL) Vol L(mL) Various studies have documented hand edema in CTS; however, these reports are for the most part limited to observations from surgical procedures, with investigators noting soft tissue and perineural edema [15,16]. Vascular sclerosis and edema were consistent findings, present in 98% and 85%, respectively, in one study [16,17].…”

Section: Idmentioning

confidence: 92%

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Hand Volume as a Diagnostic Tool in Carpal Tunnel Syndrome

Burke¹,

Bell²,

Burke³

et al. 2015

Int J Phys Med Rehabil

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Objectives: To determine whether patients with carpal tunnel syndrome have an objective swelling of their hands.Design: A prospective, cross-sectional study of consecutive patients. Setting: Two independent electromyographic laboratories.Participants: Sixty-three patients referred for electrodiagnostic work-up.Interventions: NCS/EMG testing and volumetric analysis. Limb volume was measured using the water displacement method using a volumeter. Main Outcome Measures: Differences in volume (DHV) and EMG/NCS data.Results: EMG results indicated that 24 subjects (38%) had findings consistent with CTS. Data concerning subjective swelling was available for only six of these 24 subjects. The data, which are limited by low power, indicate that there was no difference 1) between the volume of the affected hand and the unaffected hand among those with CTS; 2) between the DHV of those with CTS and those without;. 3) Patients with lower extremity complaints had significantly less DHV than those with an upper extremity complaint (p< 0.0034, excluding patients with both upper and lower extremity complaints). Conclusions:Though a patients' perception of hand swelling has previously been determined to be an indicator of CTS severity, there was no correlation found in this study between CTS and objective measures of swelling. However patients with an upper extremity complaints had a statistically larger DHV than those with a lower extremity complaint (p<0.0034), suggesting that objective swelling might be present under some unknown circumstances. As this study was limited by a low power, further investigation is warranted in this area.

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Section: Idsupporting

confidence: 79%

Section: Idmentioning

confidence: 92%

Hand Volume as a Diagnostic Tool in Carpal Tunnel Syndrome

Burke¹,

Bell²,

Burke³

et al. 2015

Int J Phys Med Rehabil

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“…In carpal tunnel syndrome (CTS), histological studies of the tenosynovium typically show edema, fibrosis, and microvascular damage [8,9,15,[19][20][21]23,26]. While the pathology of the SSCT has been characterized under light microscopy ( Fig.…”

Section: Introductionmentioning

confidence: 99%

Immunolocalization of collagen types in the subsynovial connective tissue within the carpal tunnel in humans

Jinrok¹,

Zhao²,

Amadio³

et al. 2005

Journal Orthopaedic Research

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The tenosynovium within the carpal tunnel consists of a single layer of synovial cells, which lines the bursae within the carpal tunnel, and the subsynovial connective tissue (SSCT), which contains the tendon vasculature and other structural elements. In this study, we used immunogold labeling to localize collagen types within the SSCT in three cadaver specimens and three patients with carpal tunnel syndrome. Positive labeling for collagen types I, 111 and VI was found with immunoelectron microscopy. Collagen types I and 111 were codistributed within the SSCT. Type VI was primarily located in microfibrillar structures between collagen bundles, between elastin and collagen bundles and between collagen bundles and cells. There was no difference in the distribution of collagen types when comparing cadaver specimens and carpal tunnel patients.

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“…There are many studies regarding the histopathological changes in idiopathic CTS (6,7,(9)(10)(11)13). Donato et al (6) performed a study on idiopathic CTS in 19 female and 7 male patients and found fibrosis and vascular proliferation in the subsynovial connective tissue.…”

Section: █ Resultsmentioning

confidence: 99%