Palmar bowing of the flexor retinaculum on wrist MRI correlates with subjective reports of pain in carpal tunnel syndrome.
OBJECTIVE
To investigate the utility of palmar bowing of the flexor retinaculum (PBFR) on magnetic resonance imaging (MRI) as an adjunct to presurgical evaluation of carpal tunnel syndrome (CTS).


METHODS
The CTS group comprised 48 women with CTS diagnosed from clinical history, physical examination, and electrophysiological findings. Another 21 healthy women with no symptoms of CTS served as controls. The CTS group was divided into four subgroups based on symptom duration. CTS patients were preoperatively assessed for symptom severity using a Likert scale. In both groups, palmar bowing of the flexor retinaculum (PBFR) was measured on MRI. Furthermore, relationships with disease duration, subjective symptom severity, and electrophysiological findings were assessed in the CTS group.


RESULTS
Although PBFR increased significantly in all CTS groups when compared to the control group, PBFR in patients who complained of severe pain tended to exceed that in patients with mild to moderate pain. Statistical analysis showed a positive correlation between PBFR and pain severity. In contrast, PBFR did not reflect median nerve function.


CONCLUSIONS
PBFR as seen on MRI seems to correlate significantly with patients' subjective reports of pain severity.
Tsujii
Masaya
M
Department of Orthopaedic Surgery, Mie University Faculty of Medicine, Mie, Japan. m-t727@clin.medic.mie-u.ac.jp
Hirata
Hithoshi
H
Morita
Akimasa
A
Uchida
Atsumasa
A
D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis* / Q000517:prevention & control*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013710:Tendons / Q000473:pathology* / Q000601:surgery; D014955:Wrist Joint / Q000473:pathology* / Q000601:surgery