Department of Radiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad-Pakistan.
J Ayub Med Coll Abbottabad. 2022 Apr-Jun;34(2):295-299. doi: 10.55519/JAMC-02-9892.
Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy caused by compression of median nerve at wrist as it passes through Osseo fibrous canal known as carpal tunnel. Epidemiological statistics shows one in every ten people develops the disease at any stage of life. CTS mostly affect females than males with mean age of 50. Clinical features are considered to be enough for establishing the diagnosis of carpal tunnel syndrome. However, nerve conduction studies give quantitative information regarding median nerve function therefore good at predicting outcome of intervention. Ultrasound being easily available, cost effective and real time is a promising modality for diagnosis and grading carpal tunnel syndrome.
This correlational study was conducted in collaboration of Neurology and Radiology Department of Pakistan Institute of Medical Sciences, Islamabad from January 2018 to January 2019. Total 50 patients with 85 wrists involved were included in the study. All patients with positive nerve conduction study were included. Patient with history of wrist trauma were not included. Detailed history and clinical features were recorded. All patients with positive result on nerve conduction studies underwent ultrasound examinations. Fifty control wrists were also included to establish the normal median nerve cross sectional area value in our study population. Results were recorded. Data was analyzed and appropriate statistical tests were applied by using SPSS v20.
Mean cross sectional area of median nerve for controls was 6.34±1.23. Mean cross sectional area of median nerve for mild CTS was 8.05±1.72, moderate CTS was 11.15±2.32, severe was 17.49±4.93. Strong correlation was found between (r=0.76, p-value <0.0001) between increased cross-sectional area on Ultrasonography and severity of CTS on NCS. Other finding on Ultrasonography included flattening in 4 and fluid in 10 affected wrists.
Increased cross-sectional area on Ultrasonography and severity of carpal tunnel syndrome on nerve conduction studies are very strongly correlated.
腕管综合征（CTS）是最常见的神经卡压性神经病，由正中神经在穿过腕部的骨纤维管（即腕管）时受压引起。流行病学统计显示，每 10 人中就有 1 人在生命的某个阶段患上这种疾病。CTS 多见于女性，多于男性，平均发病年龄为 50 岁。临床特征被认为足以确立腕管综合征的诊断。然而，神经传导研究提供了正中神经功能的定量信息，因此非常有助于预测干预的结果。超声检查具有易于获得、成本效益高和实时性的特点，是诊断和分级腕管综合征的一种很有前途的方法。
本研究为 2018 年 1 月至 2019 年 1 月巴基斯坦医学科学院神经病学和放射科合作进行的相关性研究。共纳入 50 例患者（85 只腕部）。所有神经传导研究阳性的患者均纳入本研究。不包括有腕部外伤史的患者。记录详细的病史和临床特征。所有神经传导研究阳性的患者均进行超声检查。还纳入 50 例对照腕部以确定本研究人群正中神经横截面积的正常值。记录结果。应用 SPSS v20 进行数据分析和适当的统计学检验。
对照组正中神经的平均横截面积为 6.34±1.23。轻度 CTS 的平均横截面积为 8.05±1.72，中度 CTS 为 11.15±2.32，重度 CTS 为 17.49±4.93。超声检查中横截面积的增加与神经传导研究中 CTS 的严重程度之间存在很强的相关性（r=0.76，p<0.0001）。超声检查中的其他发现包括 4 只腕部变平，10 只腕部有积液。
超声检查中横截面积的增加与神经传导研究中腕管综合征的严重程度有很强的相关性。
