Dilokhuttakarn Thitinut, Naito Kiyohito, Kinoshita Mayuko, Sugiyama Yoichi, Goto Kenji, Iwase Yoshiyuki, Kaneko Kazuo
Department of Orthopaedics, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Department of Orthopaedics, Srinakharinwirot University, Nakhon Nayok 26120, Thailand.
Exp Ther Med. 2017 Sep;14(3):2025-2030. doi: 10.3892/etm.2017.4743. Epub 2017 Jul 9.
In the present study, the thenar muscles were evaluated using magnetic resonance imaging (MRI), in addition, the correlations between thenar muscle changes, clinical findings and electrodiagnostic results from patients with carpal tunnel syndrome were investigated. The subjects were 13 patients (17 wrists) who were clinically diagnosed with carpal tunnel syndrome. In all patients, a medical history was obtained and physical examination was performed, in addition to assessment using the Kapandji scoring system, visual analogue scale (VAS), quick-disabilities of the arm, shoulder and hand (Q-DASH) score, electrodiagnostic results of the median nerve, and MRI of the thenar muscles. Thenar muscle volume was not significantly correlated with clinical data or the electrodiagnostic results. The thenar muscle major axis was significantly correlated with grasp power (P<0.05) and the Kapandji score (P<0.05), while the thenar muscle minor axis was significantly correlated with abductor pollicis brevis distal motor latency (APB DML) (P<0.01). In addition, the thenar muscle minor axis/thenar muscle major axis ratio was significantly correlated with APB DML and Kanatani's stage. Notably, thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes, while the grasp power and Kapandji score were correlated with thenar muscle thickness. Furthermore, it was demonstrated that thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes; in addition, there was a significant correlation between the thenar muscle major axis and the grasp power or Kapandji score. Taken together, these results revealed that thenar muscle atrophy did not affect patient-based assessments, including VAS and Q-DASH, but reflected electrodiagnostic results, particularly DML and severity. The results of the present study suggest that thenar muscle atrophy can be used to estimate the severity of carpal tunnel syndrome.
在本研究中，使用磁共振成像（MRI）对大鱼际肌进行评估，此外，还研究了腕管综合征患者大鱼际肌变化、临床发现与电诊断结果之间的相关性。研究对象为13例临床诊断为腕管综合征的患者（17只手腕）。所有患者均获取了病史并进行了体格检查，此外还使用了卡潘迪评分系统、视觉模拟量表（VAS）、手臂、肩部和手部快速残疾量表（Q-DASH）评分、正中神经的电诊断结果以及大鱼际肌的MRI进行评估。大鱼际肌体积与临床数据或电诊断结果无显著相关性。大鱼际肌长轴与握力（P<0.05）和卡潘迪评分（P<0.05）显著相关，而大鱼际肌短轴与拇短展肌远端运动潜伏期（APB DML）显著相关（P<0.01）。此外，大鱼际肌短轴/大鱼际肌长轴比值与APB DML和金谷阶段显著相关。值得注意的是，大鱼际肌变薄与电诊断变化的严重程度显著相关，而握力和卡潘迪评分与大鱼际肌厚度相关。此外，还证明大鱼际肌变薄与电诊断变化的严重程度显著相关；此外，大鱼际肌长轴与握力或卡潘迪评分之间存在显著相关性。综上所述，这些结果表明大鱼际肌萎缩不影响基于患者的评估，包括VAS和Q-DASH，但反映了电诊断结果，特别是DML和严重程度。本研究结果表明，大鱼际肌萎缩可用于评估腕管综合征的严重程度。
