Abstract
Objective
To investigate the possible association of external and ultrasonographic measurements
of the hand and wrist with median nerve conduction studies.
Design
Two group comparison study.
Setting
Outpatient neurophysiology laboratory and radiology department in a university hospital.
Participants
Patient group (n=50; 40 women) with clinically overt and electrophysiologically proven
idiopathic carpal tunnel syndrome and a control group of age- and sex-matched healthy
volunteers (n=50).
Interventions
Not applicable.
Main Outcome Measures
The following measurements were taken: (1) motor and sensory conduction studies of
the median nerve; (2) external hand and wrist dimensions (hand ratio and wrist ratio);
and (3) ultrasonographic dimensions of the carpal tunnel (carpal tunnel inlet ratio
and carpal tunnel outlet ratio) and inlet cross-sectional area and outlet cross-sectional
area of the median nerve at the tunnel.
Results
Differences between patients and controls were significant for hand and wrist ratios
and all ultrasonographic dimensions. Sensory conduction velocity and distal motor
latency of the median nerve in all 100 subjects were well correlated with hand ratio,
wrist ratio, carpal tunnel inlet ratio, and carpal tunnel outlet ratio estimates.
Wrist ratio was significantly correlated with carpal tunnel inlet ratio and carpal
tunnel outlet ratio.
Conclusions
A particular hand and wrist configuration, that is, short and wide hand with square
wrist matching to narrow and deep tunnel entrance demonstrated increased liability
for idiopathic carpal tunnel syndrome. For screening purposes, it was suggested that
simple external hand or wrist measurements could be used to predict the tendency for
carpal tunnel syndrome.
Keywords
List of abbreviations:
BMI (body mass index), CSA (cross-sectional area), CSAin (inlet cross-sectional area), CSAout (outlet cross-sectional area), CTR (carpal tunnel ratio), CTRin (carpal tunnel inlet ratio), CTRout (carpal tunnel outlet ratio), CTS (carpal tunnel syndrome), DML (distal motor latency), HR (hand ratio), ICTS (idiopathic carpal tunnel syndrome), SCV (sensory conduction velocity), WR (wrist ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 23, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.