title: Gender influence on clinical presentation and high-resolution ultrasound findings in primary carpal tunnel syndrome: do women only differ in incidence?
abstract: OBJECTIVE
  High-resolution ultrasound is increasingly used in the diagnosis of carpal tunnel syndrome; yet little is known about gender differences in clinical presentation and ultrasound findings.
  
  
  METHODS
  In this high-resolution ultrasound-based retrospective study in 170 cases, we assessed gender influence in CTS in terms of the severity of neural alterations by wrist-to-forearm ratio (WFR), epineural thickening, loss of fascicular anatomy, as well as classical signs and symptoms. The control group consisted of 42 wrists.
  
  
  RESULTS
  Women present with a greater WFR at first admission are affected more often bilaterally, and report less subjective pain intensity, while men report fewer nightly pain episodes at higher WFR. Loss of fascicular anatomy is three times more frequent in women. An increase in epineural thickness, loss of fascicular anatomy, and involvement of more than 1.5 fingers correlate significantly with WFR regardless of sex.
  
  
  CONCLUSIONS
  Women differ significantly from men in terms of clinical presentation and ultrasound findings upon first diagnosis of CTS, which should be included in further diagnostic considerations.
authors.affiliation: Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Leonhard
authors.initials: L
authors.lastname: Gruber
authors.affiliation: Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Hannes
authors.initials: H
authors.lastname: Gruber
authors.affiliation: Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Tanja
authors.initials: T
authors.lastname: Djurdjevic
authors.affiliation: Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Schullian
authors.affiliation: Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria. alexander.loizides@i-med.ac.at.
authors.forename: Alexander
authors.initials: A
authors.lastname: Loizides
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010147:Pain Measurement; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012737:Sex Factors; D014463:Ultrasonography; D014953:Wrist / Q000000981:diagnostic imaging* / Q000294:innervation / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult
keywords: CTS; Carpal tunnel syndrome; Gender influence; HRUS; High-resolution ultrasound; Pain