Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Neurological Institute, Neuromuscular Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Muscle Nerve. 2021 May;63(5):661-667. doi: 10.1002/mus.27148. Epub 2021 Jan 9.
Carpal tunnel syndrome (CTS) may be associated with structural lesions or anatomical variations at the wrist, especially in patients whose symptoms are more severe in, or limited to, the nondominant hand. The aims of this study were to identify the type and frequency of structural abnormalities and anatomical variations, and to demonstrate the contribution of ultrasound in this subgroup of CTS patients.
A retrospective chart review was performed on all patients referred to the electromyography laboratory who fulfilled the diagnostic criteria for CTS and who underwent neuromuscular ultrasound.
Of 114 CTS patients with symptoms mainly in nondominant hand, 51 (44.7%) had structural abnormalities or anatomical variations detected by ultrasound. In multivariable analysis, symptoms mainly in the nondominant hand and a body mass index (BMI) <30 kg/m were the only independent variables significantly associated with structural findings, odds ratios 2.3 (P < .001) and 1.9 (P = .006), respectively.
Neuromuscular ultrasound, in addition to electrodiagnostic studies, should be considered in all CTS patients with symptoms more severe in nondominant hand as a significant number have abnormal structural abnormalities or anatomical variations that may be causative or change the therapeutic approach.
腕管综合征（CTS）可能与手腕处的结构损伤或解剖变异有关，尤其是在症状主要出现在非优势手，或仅局限于非优势手的患者中。本研究的目的是确定结构异常和解剖变异的类型和频率，并展示超声在这组 CTS 患者中的作用。
对所有符合 CTS 诊断标准并接受神经肌肉超声检查的肌电图实验室转介患者进行回顾性图表审查。
在 114 例以非优势手为主诉的 CTS 患者中，51 例（44.7%）通过超声检查发现结构异常或解剖变异。在多变量分析中，症状主要出现在非优势手和体重指数（BMI）<30kg/m2是非优势手症状与结构发现显著相关的唯一独立变量，比值比分别为 2.3（P<.001）和 1.9（P=0.006）。
除电诊断研究外，对于症状主要出现在非优势手的所有 CTS 患者，都应考虑进行神经肌肉超声检查，因为相当一部分患者存在可能导致或改变治疗方法的异常结构异常或解剖变异。
