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45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

Carpal tunnel syndrome in rheumatoid arthritis patients: evaluation of the depth by ultrasonography

Meeting Abstract

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  • Ahmed Elsaman - Sohag University, Rheumatology Department, Sohag, Egypt
  • Ahmed Hamed - Minia University, Rheumatology, Minia, Egypt
  • Ahmed Borai - Sohag university, neurology department, Neurology, Sohag, Egypt
  • Ahmed Radwan - Sohag university, faculty of medicine, Rheumatology, Sohag, Egypt

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocRA.26

doi: 10.3205/17dgrh172, urn:nbn:de:0183-17dgrh1721

Published: September 4, 2017

© 2017 Elsaman et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Ultrasound (US) is one of the most widely used tools for diagnosis and evaluation of carpal tunnel syndrome (CTS). US achievement is comparable to the gold standard electrophysiological studies. Depth of the carpal tunnel is a promising, relatively new sonographic parameter used for assessment of the CTS. Previously it was evaluated in cadavers, normal individuals and in idiopathic carpal tunnel and it was not adequately adressed in rheumatoid arthritis (RA).

Methods: Electrophysiology was used a s a gold standard and US parameters like depth of the carpal tunnel (DCT), cross sectional area (CSA) and flattening ratio (FR) were considered. The study was conducted in 123 non-diabetic RA patients having carpal tunnel syndrome (unilateral n=85, bilateral n=38) evidenced by electrophysiological diagnosis according to the criteria of the American Association of Electrodiagnostic Medicine. Furthermore, 40 hands from 20 healthy volunteers were considered as control group.

Results: The mean age of the patients was 39.1±8.58 years. The female to male ratio was 96:27 in CTS patients. The difference between patients and healthy controls was significant in all three parameters and was highest at the DCT, followed by CSA and then FR. A positive and significant relation was found between and tenosynovitis and US measures of the median nerve, being most evident with DCT (p<0.001) followed by CSA (p=), but not with FR.

Conclusion: DCT is a new promising method for the detection of CTS. DCT increased obviously in RA patients with CTS, and this augmentation was related to tenosynovitis more than synovitis. Much more work is needed to evaluate this parameter in different types of CTS.