Department of Physical Medicine and Rehabilitation, Cumra State Hospital, Konya, 42500, Turkey.
Department of Physical Medicine and Rehabilitation, Selcuk University Medical Faculty, Konya, Turkey.
Ir J Med Sci. 2024 Apr;193(2):977-985. doi: 10.1007/s11845-023-03512-5. Epub 2023 Sep 6.
Carpal tunnel syndrome (CTS) is a type of peripheral entrapment neuropathy and common for the patients with psoriatic arthritis (PsA). Shear wave elastography (SWE) is a new ultrasonography technique that can be used for diagnosing CTS, but not studied in PsA patients.
The aim of this study to measure the stiffness of median nerve and hand muscles by quantitative SWE to identify whether SWE can be used for diagnosing CTS in patients with PsA or not.
To diagnose CTS, all patients had electrodiagnostic study. The stiffness values of the median nerve, abductor pollicis brevis, and abductor digiti minimi were determined using SWE. Muscle stiffness ratio was also calculated.
Consideration is given to 48 patients with PsA (93 wrists) and 29 healthy volunteers (57 wrists). Median nerve stiffness was found to be significantly higher, and abductor pollicis brevis' stiffness and muscle stiffness ratio were significantly lower in PsA patients' wrists compared to control group (p = 0.002, p < 0.001, p = 0.001, respectively) and in CTS wrists compared to others (p < 0.001, p < 0.001, p = 0.001, respectively). Receiver operating characteristic analysis identified 28.2 kPA as the median nerve stiffness cut-off point for differentiating CTS in PsA patients (p = 0.001).
We found that SWE has a good diagnostic value for CTS with PsA patients; hence, we can conclude that SWE could diagnose CTS in PsA patients.
腕管综合征(CTS)是一种周围神经卡压性疾病,常见于银屑病关节炎(PsA)患者。剪切波弹性成像(SWE)是一种新的超声技术,可用于诊断 CTS,但尚未在 PsA 患者中进行研究。
本研究旨在通过定量 SWE 测量正中神经和手部肌肉的硬度,以确定 SWE 是否可用于诊断 PsA 患者的 CTS。
为了诊断 CTS,所有患者均进行了电诊断研究。使用 SWE 确定正中神经、拇短展肌和小指展肌的硬度值。还计算了肌肉硬度比。
共纳入 48 例 PsA 患者(93 腕)和 29 名健康志愿者(57 腕)。与对照组相比,PsA 患者腕部正中神经硬度明显升高,拇短展肌硬度和肌肉硬度比明显降低(p=0.002,p<0.001,p=0.001),与其他腕部相比,CTS 腕部也明显升高(p<0.001,p<0.001,p=0.001)。受试者工作特征曲线分析确定 28.2 kPA 为区分 PsA 患者 CTS 的正中神经硬度截断点(p=0.001)。
我们发现 SWE 对有 PsA 的 CTS 具有良好的诊断价值;因此,我们可以得出结论,SWE 可以诊断 PsA 患者的 CTS。