Standard ultrasonographic approach in the carpal tunnel syndrome
Keywords:
ultrasonography, carpal tunnel syndromeAbstract
OBJECTIVE:To propose a standard ultrasonographic approach in the carpal tunnel syndrome (CTS). MATERIAL AND METHODS: Forty two female patients, 21 asymptomatic and 21 bilateral symptomatic for CTS, were evaluated by ultrasonographic imaging of the wrist. The folowing measures were acquired: proximal transverse distance (PTD), distal transverse distance (DTD), antero-posterior distance (APD), cross-sectional area of the median nerve at the tunnel inlet (CSA), and flexor retinaculum thickness (FRT). Nerve entrapment and increased flexor tendons visibility were assessed by dynamical evaluation. Evaluation of the data was conducted by comparing the two groups variables. Confidence level was fixed in 95%. RESULTS: APD, CSA and FRT measures were signicantly higher in symptomatic pacients (p < 0,001). Nerve entrapment and tendon increased visibility frequencies were also increased in this group (p < 0,001 and p = 0,001 for right wrist, p = 0,001 e p < 0,001 for left wrist, respectively). PTD and DTD did not differ significantly in the groups. CONCLUSIONS:CSA is the most important measure in the basic proposed evaluation scheme. DPA, FRT and the dinamic transversal and longitudinal evaluation may be added to the scheme. PTD and DTD may be used for pre and post-surgical studies.
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