Enlarged median nerve in idiopathic carpal tunnel syndrome.
To delineate change in median nerve size in carpal tunnel syndrome (CTS), we compared ultrasonograms of nerve cross-sections from patients (201 wrists of 125 women with idiopathic CTS) and controls (200 dominant wrists of 200 women). Major and minor axes, cross-sectional area, and the flattening ratio (major axis/minor axis) were measured at four levels: 1, distal edge of the flexor retinaculum; 2, center of the hook of the hamate; 3, wrist crease; and 4, distal one-third level of the forearm. Axes and areas were greater in the patients at levels 1, 2, and 3. The flattening ratio was greater in the controls at levels 1 and 2, and in the patients at level 3. When the groups were combined, there were linear correlations between the cross-sectional nerve area and electrophysiologic severity at levels 1, 2, and 3. These findings indicate that idiopathic CTS is characterized by severity-correlated intracarpal enlargement of the median nerve and not by compressive deformation, such as a reduction in the caliber of the nerve.
Nakamichi
K I
KI
Department of Orthopaedic Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
Tachibana
S
S
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008475:Median Nerve / Q000473:pathology*; D008875:Middle Aged; D009431:Neural Conduction; D009475:Neurons, Afferent / Q000502:physiology; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000592:standards