title: Ultrasonographic assessment of longitudinal median nerve and hand flexor tendon dynamics in carpal tunnel syndrome.
abstract: BACKGROUND
  Changes in subsynovial connective tissue (SSCT) in carpal tunnel syndrome (CTS) patients may result in altered dynamics; consequently, quantification of these dynamics might support objective diagnosis of CTS.
  
  
  METHODS
  We measured and compared longitudinal excursion of the flexor digitorum superficialis and profundus tendons, the median nerve, and the SSCT between the most and least affected hands of 51 CTS patients during extension-to-fist motion.
  
  
  RESULTS
  Median nerve and flexor digitorum superficialis tendon excursions in the most affected hands were smaller than in the least affected hands of the same patients, whereas the excursions of the flexor digitorum profundus were larger. Based on these excursions, logistic regression models classified between 67% and 86% of the hands correctly as having CTS.
  
  
  CONCLUSIONS
  The altered hand dynamics in CTS patients may have implications for the pathophysiology and clinical evaluation of CTS, and ultrasound-based classification models may further support the diagnosis of CTS.
authors.affiliation: Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000CA Rotterdam, The Netherlands. j.korstanje@erasmusmc.nl
authors.forename: Jan-Wiebe H
authors.initials: JW
authors.lastname: Korstanje
authors.forename: Marjan
authors.initials: M
authors.lastname: Scheltens-De Boer
authors.forename: Joleen H
authors.initials: JH
authors.lastname: Blok
authors.forename: Peter C
authors.initials: PC
authors.lastname: Amadio
authors.forename: Steven E R
authors.initials: SE
authors.lastname: Hovius
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000367:Age Factors; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006225:Hand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D017711:Nonlinear Dynamics; D018709:Statistics, Nonparametric; D013710:Tendons / Q000503:physiopathology*; D018608:Ultrasonography, Doppler