Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome

Anika Filius, Marjan Scheltens, Hans G. Bosch, Pieter A. van Doorn, Henk J. Stam, Steven E. R. Hovius, Peter C. Amadio, Ruud W. Selles
2015 Journal of Orthopaedic Research  
Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape
more » ... changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤0.019), increased nerve cross-sectional area (p≤0.006) and perimeter (p≤0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70-71% and specificity of 80-84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. Results The majority of controls and CTS patients (29 controls (69%) and 90 patients (80%) respectively) were recruited and imaged at the Erasmus Medical Centre; 13 controls (31%) and 23 patients (20%) were included at the Mayo Clinic. The control and patient group Filius et al. Placement of the region of interest (ROI) for A. The MN with SSCT. B. The FDS3 with SSCT. C. The FDP3 with SSCT. Filius et al.
doi:10.1002/jor.22909 pmid:25865180 pmcid:PMC4529801 fatcat:qoqpph6mqnb4havb3iudsr7vhy