title: Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome.
abstract: Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross-sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70-71% and specificity of 80-84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel.
authors: Department of Plastic Reconstructive Surgery and Hand Surgery, Erasmus MC University Medical Centre, Rotterdam, Netherlands.|Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.|Biomechanics Laboratory, Division of Orthopedic Research, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Anika
authors: A
authors: Filius
authors: Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
authors: Marjan
authors: M
authors: Scheltens
authors: Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands.
authors: Hans G
authors: HG
authors: Bosch
authors: Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
authors: Pieter A
authors: PA
authors: van Doorn
authors: Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
authors: Henk J
authors: HJ
authors: Stam
authors: Department of Plastic Reconstructive Surgery and Hand Surgery, Erasmus MC University Medical Centre, Rotterdam, Netherlands.
authors: Steven E R
authors: SE
authors: Hovius
authors: Biomechanics Laboratory, Division of Orthopedic Research, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Peter C
authors: PC
authors: Amadio
authors: Department of Plastic Reconstructive Surgery and Hand Surgery, Erasmus MC University Medical Centre, Rotterdam, Netherlands.|Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
authors: Ruud W
authors: RW
authors: Selles
mesh_terms: D000328:Adult; D000465:Algorithms; D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D013710:Tendons / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods*; D014953:Wrist / Q000000981:diagnostic imaging; D014955:Wrist Joint / Q000000981:diagnostic imaging
keywords: Carpal tunnel syndrome; biomechanics; displacement; tendon; ultrasound