Ultrasound Measurement of the Median Nerve for Carpal Tunnel Syndrome of the Non-handicapped and the Handicapped

Abstract

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and is often complicated by overuse the wrist in paraplegic and hemiplegic patients. The aim of this study was to determine the usefulness of ultrasound measurements and their best diagnostic criterion for CTS, and to reveal the feature of CTS among paraplegic and hemiplegic patients. Ninety-four patients with 132 wrists clinically and electrophysiologically diagnosed CTS, and 137 asymptomatic controls matched for age and sex were enrolled. Three ultrasound measurements were assessed: major and minor diameters, cross-sectional areas, and flattening ratios at pisiform bone and hook of hamate bone levels. Values for each of the three variables without flattening ratios of pisiform bone level were significantly different in CTS population compared to control population. Also, a strong relationship was found between the severity and the enlargement of the median nerve. Total cross sectional areas at the pisiform and hook of hamate levels larger than 16 mm2 proved to be highly predictive of CTS. The incidence of CTS among hemiplegic and paraplegic patients fully independent of ADL was 8.5%. These handicapped CTS indicated no significant ultrasound values compared to other non-handicapped CTS.