title: Evaluation of Radiographic Instability of the Trapeziometacarpal Joint in Women With Carpal Tunnel Syndrome.
abstract: OBJECTIVE
  To determine whether median nerve dysfunction measured by electrophysiologic studies in carpal tunnel syndrome (CTS) is associated with thumb trapeziometacarpal (TMC) joint instability.
  
  
  METHODS
  We evaluated 71 women with CTS and 31 asymptomatic control women. Patients with generalized laxity or TMC joint osteoarthritis were excluded. We classified the electrophysiologic severity of CTS based on nerve conduction time and amplitude and assessed radiographic instability of the TMC joint based on TMC joint stress radiographs. We compared subluxation ratio between patients with CTS and controls and performed correlation analysis of the relationship between the electrophysiologic grade and subluxation ratio.
  
  
  RESULTS
  Thirty-one patients were categorized into the mild CTS subgroup and 41 into the severe CTS subgroup. There was no significant difference in subluxation ratio between the control group and CTS patients or between the control group and CTS subgroup patients. Furthermore, there was no significant correlation between electrophysiologic grade and subluxation ratio.
  
  
  CONCLUSIONS
  This study demonstrated that patients with CTS did not have greater radiographic TMC joint instability compared with controls, and suggests that TMC joint stability is not affected by impaired median nerve function. Further studies could investigate how to better evaluate proprioceptive function of TMC joint and whether other nerves have effects on TMC joint motor/proprioceptive function, to elucidate the relationship between neuromuscular control of the TMC joint, its stability, and its progression to osteoarthritis.
  
  
  METHODS
  Diagnostic II.
authors.affiliation: Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. Electronic address: hsgong@snu.ac.kr.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Rhee
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jihyoung
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016022:Case-Control Studies; D004568:Electrodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D051222:Trapezium Bone / Q000000981:diagnostic imaging*
keywords: Instability; carpal tunnel syndrome; median nerve; osteoarthritis; trapeziometacarpal joint