特发性腕管综合征患者手腕的影像学特征
Radiographic characteristics of wrists in idiopathic carpal tunnel syndrome patients.
作者信息
Ikeda Kazuhiro, Yoshii Yuichi, Ogawa Takeshi, Ishii Tomoo
机构信息
Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
Department of Orthopaedic Surgery, Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center, Mito, 310-0015, Japan.
出版信息
BMC Musculoskelet Disord. 2020 Apr 15;21(1):245. doi: 10.1186/s12891-020-03254-w.
BACKGROUND
To determine the radiographic characteristics of wrists in idiopathic carpal tunnel syndrome patients, we compared the radiographic parameters of the wrists between carpal tunnel syndrome patients and non-symptomatic controls.
METHODS
We evaluated radiographic parameters of 94 wrists of 62 idiopathic carpal tunnel syndrome patients and 94 asymptomatic wrists of 94 controls. Carpal tunnel syndrome was diagnosed by clinical findings and nerve conduction studies. The lack of symptoms was confirmed with the medical records and interviews for the controls. X-ray images of the postero-anterior and lateral views of the wrist were taken. Using the obtained X-ray images, the indices of radial inclination, volar tilt, ulnar variance, and transverse and antero-posterior diameters of the wrists were measured. Two raters independently performed the measurement. One rater measured without information of clinical symptoms. Inter-rater reliabilities for each parameter were evaluated by the intra-class correlation coefficients. The averages of the measurements of two raters were compared between the carpal tunnel syndrome patients and the controls.
RESULTS
The intra-class correlation coefficients were 0.58 for radial inclination, 0.77 for ulnar variance, 0.99 for transverse diameter, 0.60 for volar tilt, and 0.91 for antero-posterior diameter. Statistically significant correlations were found for all parameters (P < 0.01). The ulnar variance was significantly larger in the carpal tunnel syndrome patients compared to the controls (1.7 +/- 1.8 mm and 0.8 +/- 1.5 mm for the patients and controls, respectively P < 0.01). There were no significant differences in the other parameters.
CONCLUSIONS
Significant differences in the ulnar variance were observed between carpal tunnel syndrome patients and controls. This suggests that the imbalance of radioulnar bone length is one of the risk factors to develop carpal tunnel syndrome. The positive ulnar variance may be an index that needs attention to the development of carpal tunnel syndrome.
LEVEL OF EVIDENCE
level III, a case control study.
背景
为了确定特发性腕管综合征患者手腕的影像学特征，我们比较了腕管综合征患者与无症状对照者手腕的影像学参数。
方法
我们评估了62例特发性腕管综合征患者的94只手腕以及94例对照者的94只无症状手腕的影像学参数。腕管综合征通过临床检查结果和神经传导研究进行诊断。对照者通过病历记录和访谈确认无症状。拍摄手腕的后前位和侧位X线图像。利用获得的X线图像，测量手腕的桡偏角、掌倾角、尺骨变异、横径和前后径等指标。两名评估者独立进行测量。一名评估者在不知道临床症状信息的情况下进行测量。通过组内相关系数评估各参数的评估者间信度。比较腕管综合征患者和对照者两名评估者测量结果的平均值。
结果
桡偏角的组内相关系数为0.58，尺骨变异为0.77，横径为0.99，掌倾角为0.60，前后径为0.91。所有参数均存在统计学显著相关性（P < 0.01）。与对照者相比，腕管综合征患者的尺骨变异显著更大（患者和对照者分别为1.7±1.8 mm和0.8±1.5 mm，P < 0.01）。其他参数无显著差异。
结论
腕管综合征患者与对照者之间观察到尺骨变异存在显著差异。这表明桡尺骨长度不平衡是发生腕管综合征的危险因素之一。正性尺骨变异可能是一个需要关注腕管综合征发生的指标。
证据级别
III级，病例对照研究。
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