gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Artikel

Artikel empfehlen

Use of ultrasonography in carpal tunnel syndrome diagnosis

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Mihaela Pertea - University of Medicine and Pharmacy Gr. T. Popa, Sf. Spiridon Emergengy Hospital, Iasi, Romania
  • Sergiu Ursu - University of Medicine and Pharmacy N. Testemitanu, Orthopaedisc and Traumatology Clinic, Chisinau, Moldova
  • Oxana-Madalina Grosu - University of Medicine and Pharmacy Gr. T. Popa, Sf. Spiridon Emergengy Hospital, Iasi, Romania

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1200

doi: 10.3205/19ifssh0638, urn:nbn:de:0183-19ifssh06383

Veröffentlicht: 6. Februar 2020

© 2020 Pertea et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: The aim of the paper was to analyze the effectiveness of ultrasonography in diagnosing carpal tunnel syndrome (CTS), to propose the use of sonographic index of median nerve in carpal tunnel (SIMNCT), and developing a diagnostic algorithm.

Methods: We study a group of 344 patients with SCC symptoms were examined with ultrasonography. The size of the cross-sectional area of the median nerve was measured at carpal tunnel inlet and outlet, nerve morphology at passage through carpal tunnel and the analysis of the neighboring structures, with the purpose of possibly determining the disease etiology. In all patients, we examined, in the affected hand, the vertical thickness of median nerve (MN) as entering into the carpal tunnel (CT) - G1, the lowest vertical thickness in the CT or leaving the CT - G2, the thickness of the MN in the transverse plane, as entering in the CT - L. Normal values were considered the similar measurements in healthy contralateral hand. We proposed the SIMNCT calculation after the formula: SIMNCT = 100% (1-G2 / G1). We have established normal value in the healthy hand as SIMNCT = 16%.

Results: We demonstrated a statistically significant sensitivity of median nerve sonographic index at carpal tunnel level (p <0.0001) compared with cross-sectional area (CSA) and flattening ratio in the diagnosis of CTS. By analyzing the SIMNCT, developed by us, with a higher value than 16%, we demonstrated a sensitivity of 94.81% and a specificity of 99.66% in establishing the diagnosis of CTS. Thus, we proposed a classification of the severity of CTS according to the SIMNCT: normal = 16%, mild = 16-19%, moderate = 19-28%, severe = 28-50%, very severe over 50%.

Conclusions: Ultrasound is an effective method of studying the morphology of the tunnel and compressed nerve at various CTS stages and of determining the cause of compression in patients this disease. The median nerve sonographic index at the level of the carpal tunnel is a valuable and practical indicator and it can be used in the diagnosis of CTS and, also, it may be helpful in determining the severity of lesion. Is has a more valuable significance than the flattening ratio (sensitivity 4,49%, specificity 97,95%) and the cross-sectional area (sensitivity 88,76%, specificity 32,08%).