title: Pathological changes in the subsynovial connective tissue increase with self-reported carpal tunnel syndrome symptoms.
abstract: BACKGROUND
  Fibrosis and thickening of the subysnovial connective tissue are the most common pathological findings in carpal tunnel syndrome. The relationship between subsynovial connective tissue characteristics and self-reported carpal tunnel syndrome symptoms was assessed.
  
  
  METHODS
  Symptoms were characterized using the Boston Carpal Tunnel Questionnaire and Katz hand diagram in twenty-two participants (11 with symptoms, 11 with no symptoms). Using ultrasound, the thickness of the subsynovial connective tissue was measured using a thickness ratio (subsynovial thickness/tendon thickness) and gliding function was assessed using a shear strain index ((Displacement(tendon)-Displacement(subsynovial))/Displacement(tendon)x 100). For gliding function, participants performed 10 repeated flexion-extension cycles of the middle finger at a rate of one cycle per second.
  
  
  RESULTS
  Participants with symptoms had a 38.5% greater thickness ratio and 39.2% greater shear strain index compared to participants without symptoms (p<0.05).
  
  
  CONCLUSIONS
  Ultrasound detected differences the SSCT in symptomatic group that was characterized by low self-reported symptom severity scores. This study found ultrasound useful for measuring structural and functional changes in the SSCT that could provide insight in the early pathophysiology associated with carpal tunnel syndrome symptoms.
authors.affiliation: Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Tat
authors.affiliation: Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Wilson
authors.affiliation: Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1. Electronic address: pjkeir@mcmaster.ca.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Keir
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003238:Connective Tissue / Q000000981:diagnostic imaging / Q000473:pathology* / Q000502:physiology; D005260:Female; D005355:Fibrosis; D005385:Fingers / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D033081:Shear Strength / Q000502:physiology; D011795:Surveys and Questionnaires; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000473:pathology*; D013710:Tendons / Q000502:physiology; D014463:Ultrasonography; D014953:Wrist / Q000503:physiopathology; D055815:Young Adult
keywords: Carpal tunnel syndrome; Hand; Questionnaire; Subsynovial connective tissue; Ultrasound